Individual provider Active NPI

Shelly D Boyle, PA-C

  • Physician Assistant
  • Hamilton, TX
National Provider Identifier
1235233552
Registry record updated Jun 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA04929 Issued in TX
Practice address
400 N Brown St
BLDG 1
Hamilton, TX 76531-1518
Phone
(254) 386-1600
Fax
(254) 386-5173
NPI assigned
Sep 8, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X
Physician Assistant 363A00000X PA04929 TX Primary

Addresses

Primary practice location

400 N Brown St
BLDG 1
Hamilton, TX 76531-1518

Mailing address

400 N Brown St
BLDG 1
Hamilton, TX 76531-1518
Phone (254) 386-1600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20150824001091 TX Practitioner - Physician Assistant 7618124728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hamilton County Hospital DistrictGroup PAC ID 2062326234, 24 clinicians

Practice addresses (Care Compare)

400 N Brown St
Hamilton, TX 76531-1518

Hospital & facility affiliations

  • Hamilton General Hospital Hospital, Hamilton, TX, CCN 451392

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
1928OKMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hamilton County Hospital District CurrentSince Jun 29, 2015 Accepting new patients
Hamilton County Hospital District CurrentSince Jun 29, 2015 Accepting new patients

Locations

400 N Brown St
Hamilton, TX 76531
Phone (254) 386-1600

400 N Brown St
Bldg 1
Hamilton, TX 76531
Phone (254) 386-1600

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1157673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718150400000",
    "number": "1235233552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 N BROWN ST",
            "address_2": "BLDG 1",
            "city": "HAMILTON",
            "state": "TX",
            "postal_code": "765311518",
            "telephone_number": "254-386-1600",
            "fax_number": "254-386-5173"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 N BROWN ST",
            "address_2": "BLDG 1",
            "city": "HAMILTON",
            "state": "TX",
            "postal_code": "765311518",
            "telephone_number": "254-386-1600",
            "fax_number": "254-386-5173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLE",
        "first_name": "SHELLY",
        "middle_name": "D",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-08",
        "last_updated": "2024-06-12",
        "certification_date": "2024-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA04929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hamilton, TX

Sources for this page

Verify at the official NPI Registry.