Individual provider Active NPI

Mary Beth Lewis-Boardman, MD

  • Gynecology Physician
  • Leesburg, FL
National Provider Identifier
1255385779
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
ME93877 Issued in FL
Practice address
305 S Childs St
Leesburg, FL 34748-5922
Phone
(352) 348-3008
Fax
(352) 432-1479
NPI assigned
May 20, 2006
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology Physician 207VG0400X ME93877 FL Primary

Addresses

Primary practice location

305 S Childs St
Leesburg, FL 34748-5922

Mailing address

16921 Florence View Dr
Montverde, FL 34756-3423
Phone (352) 348-3008

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20050929000932 FL Practitioner - Obstetrics/Gynecology 8224075742 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
JS Weill Medical College, Cornell University, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Woman Care LLCGroup PAC ID 5395807218, 607 clinicians

Practice addresses (Care Compare)

3000 Hunters Creek Blvd
Orlando, FL 32837-6901
Phone (407) 857-2502

5323 4TH Ave Circle E
Bradenton, FL 34208-5623
Phone (941) 745-5115

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME93877FLMDGynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Women's Care Florida LLC Obstetrics & Gynecology CurrentSince Jul 1, 2009 Accepting new patients
Womens' Health Hospitalists, LLC Obstetrics & Gynecology CurrentSince Aug 1, 2016 Accepting new patients
Florida Woman Care, LLC Obstetrics & Gynecology CurrentSince Sep 1, 2024 Accepting new patients
Planned Parenthood of Florida, Inc. Obstetrics & Gynecology Past Accepting new patients
Womencare PA Past Accepting new patients
Andrew D Karen MD LLC Obstetrics & Gynecology Past Accepting new patients

Locations

2815 S Seacrest Blvd
Ste 112
Boynton Beach, FL 33435
Phone (561) 368-0233

5323 4th Avenue Cir E
Bradenton, FL 34208
Phone (941) 745-5115

3000 Hunters Creek Blvd
Orlando, FL 32837
Phone (407) 337-8814

2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551

4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333

5002 W Lemon St
Tampa, FL 33609

2102 Trinity Oaks Blvd
#171
Trinity, FL 34655
Phone (727) 376-7734

Interoperability endpoints

  • Direct secure messaging: mary.beth.lewis-boardman.1@26576.direct.athenahealth.com
  • Direct secure messaging: marybeth.lewis-boardman.1@2183.direct.athenahealth.com

Organizations & group practices 6

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": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1255385779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16921 FLORENCE VIEW DR",
            "city": "MONTVERDE",
            "state": "FL",
            "postal_code": "347563423",
            "telephone_number": "352-348-3008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 S CHILDS ST",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347485922",
            "telephone_number": "352-348-3008",
            "fax_number": "352-432-1479"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEWIS-BOARDMAN",
        "first_name": "MARY BETH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-20",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME93877",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, FL

Sources for this page

Verify at the official NPI Registry.