Michael Scott Boxum, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

02003170A Issued in IN

Practice address

754 McCool Rd
Valparaiso, IN 46385-8856

Phone

(219) 759-5500

NPI assigned

Feb 27, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

Other, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwest Health - Porter Hospital, Valparaiso, IN, CCN 150035
• St Mary Medical Center Inc Hospital, Hobart, IN, CCN 150034

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Porter Hospital LLC

  dba Northwest Health-Porter

  • General Acute Care Hospital
  • Valparaiso, IN
  • NPI 1215151154
  Care Compare affiliation
• St Mary Medical Center Inc

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1558463745
  Care Compare affiliation
• St Mary Medical Center Inc

  dba St Mary Wound Clinic

  • General Acute Care Hospital
  • Hobart, IN
  • NPI 1962504175
  Care Compare affiliation

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

{
    "created_epoch": "1140998400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569283200000",
    "number": "1235105685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4402 SILHAVY RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463839157",
            "telephone_number": "219-465-3279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "754 MCCOOL RD",
            "city": "VALPARAISO",
            "state": "IN",
            "postal_code": "463858856",
            "telephone_number": "219-759-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOXUM",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-02-27",
        "last_updated": "2019-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "02003170A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200860670A",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "000000524369",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lynn Ann Bontrager
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• Marsha Bosseau, RN
• McKenzi Elizabeth Bowen
• Linda Nowzaradan Boxum, D.O.
• Monique Boyd
• Brad Wisowaty DDS LLC (Modern Dentistry)
• Jane Bradlaw, D.O.
• Tareq Braik, M.D.
• Jennifer L Braspenning, OTR

• Family Medicine Physician in Valparaiso, IN
• Providers in Valparaiso, IN by specialty
• Family Medicine Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2019; 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.