Individual provider Active NPI

David J Boes, DO

  • Obstetrics & Gynecology Physician
  • Lansing, MI
National Provider Identifier
1255310694
Registry record updated Jun 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
5101007502 Issued in MI
Practice address
2727 S Pennsylvania Ave
Lansing, MI 48910-3488
Phone
(517) 975-3750
Fax
(517) 975-3755
NPI assigned
Jan 13, 2006
Last updated
Jun 29, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 5101007502 MI Primary

Addresses

Primary practice location

2727 S Pennsylvania Ave
Lansing, MI 48910-3488

Mailing address

804 Service Rd
# A201
East Lansing, MI 48824-7015
Phone (517) 884-2976

Other identifiers 11

IdentifierTypeStateIssuer
1255310694MedicaidMI
HEALTH ADVANTAGEOtherMI252502
252502OtherMIMCLAREN HEALTH PLAN
4308424MedicaidMI
160C311260OtherMIBLUE CHOICE
160C311260OtherMIBLUE CARE NETWORK
0700185OtherMIPHYSICIANS HEALTH PLAN
160C311260OtherMICOMMUNITY BLUE
F04444OtherMIHEALTH NET FEDERAL SERVIC
160C311260OtherMIBLUE CROSS BLUE SHIELD
4053266OtherMIAETNA

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20100320000152 MI Practitioner - Obstetrics/Gynecology 3274668801 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Metropolitan Hospital Obstetrics & Gynecology CurrentSince Feb 2, 2015 Accepting new patients
Full Spectrum Family Medicine PC Current Accepting new patients
Obhg Michigan, PC Obstetrics & Gynecology CurrentSince Dec 1, 2015 Accepting new patients
Metropolitan Hospital CurrentSince Feb 2, 2015 Accepting new patients
McLaren Greater Lansing Obstetrics & Gynecology Past Accepting new patients

Locations

205 N East Ave
Jackson, MI 49201
Phone (517) 788-4730

781 36th St SE
Wyoming, MI 49548
Phone (616) 252-4100

Interoperability endpoints

  • Direct secure messaging: dboes54005@direct.metrohealth.net

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1137110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467158400000",
    "number": "1255310694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "804 SERVICE RD",
            "address_2": "# A201",
            "city": "EAST LANSING",
            "state": "MI",
            "postal_code": "488247015",
            "telephone_number": "517-884-2976",
            "fax_number": "517-432-3928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2727 S PENNSYLVANIA AVE",
            "city": "LANSING",
            "state": "MI",
            "postal_code": "489103488",
            "telephone_number": "517-975-3750",
            "fax_number": "517-975-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOES",
        "first_name": "DAVID",
        "middle_name": "J",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-13",
        "last_updated": "2016-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5101007502",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1255310694",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "252502",
            "identifier": "HEALTH ADVANTAGE",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MCLAREN HEALTH PLAN",
            "identifier": "252502",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4308424",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CHOICE",
            "identifier": "160C311260",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CARE NETWORK",
            "identifier": "160C311260",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICIANS HEALTH PLAN",
            "identifier": "0700185",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMMUNITY BLUE",
            "identifier": "160C311260",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH NET FEDERAL SERVIC",
            "identifier": "F04444",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "160C311260",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4053266",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lansing, MI

Sources for this page

Verify at the official NPI Registry.