Ethan Westley Boardman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

50.007417RX Issued in OH

Practice address

4885 Olentangy River Rd Ste 1-20
Columbus, OH 43214-1953

Phone

(614) 268-6555

Fax

(614) 457-5713

NPI assigned

Feb 4, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Central Ohio Primary Care Physicians, Inc.Group PAC ID 2769383785, 487 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

87.04 of 100Reported as group

Quality

85.5

Improvement activities

40

Cost

83.38

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: eboardman81136@copcp.medicity.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Central Ohio Primary Care Physicians, Inc.

  • Internal Medicine Physician
  • Westerville, OH
  • NPI 1194705194

  Physician Assistant

  Medicare reassignment Care Compare group NPD
• Central Ohio Primary Care Physicians Inc

  • Hospitalist Physician
  • Westerville, OH
  • NPI 1518398866
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1643932800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723593600000",
    "number": "1184378549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4885 OLENTANGY RIVER RD STE 1-20",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141953",
            "telephone_number": "614-268-6555",
            "fax_number": "614-457-5713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4885 OLENTANGY RIVER RD STE 1-20",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432141953",
            "telephone_number": "614-268-6555",
            "fax_number": "614-457-5713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOARDMAN",
        "first_name": "ETHAN",
        "middle_name": "WESTLEY",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-02-04",
        "last_updated": "2024-08-14",
        "certification_date": "2024-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007417RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael John Boals, APRNCNP
• Charity Boamah
• Joseph A Boampong
• Jessica Anne Board, MA, LPCC
• Sarah Grace Board, MD
• Mary Adu Boatemaa
• Animah Vanessa Boateng, DO
• Elaine Boateng, PHARMD
• Ernest Boateng
• Gloria Sefa Boateng

• Physician Assistant in Columbus, OH
• Providers in Columbus, OH by specialty
• Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.