Mary Beth Lewis-Boardman, MD
Individual provider Active NPI Gynecology Physician · Leesburg, FL
NPI 1255385779 · NPPES record last updated Sep 17, 2024
Key facts
- NPI
- 1255385779
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Gynecology Physician 207VG0400X
- License
- ME93877 (FL)
- Practice address
- 305 S Childs St
Leesburg, FL 34748-5922 - Phone
- (352) 348-3008
- Fax
- (352) 432-1479
- NPI assigned
- May 20, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare Care Compare profile
- 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 LLC
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
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20050929000932 | FL | Practitioner - Obstetrics/Gynecology | 8224075742 | Reassigns benefits to 3 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| ME93877 | FL | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Florida Woman Care, LLC | Obstetrics & Gynecology | Current |
Accepting new patients |
| Women'S Care Florida LLC | Obstetrics & Gynecology | Current |
Accepting new patients |
| Womens' Health Hospitalists, LLC | Obstetrics & Gynecology | Current |
Accepting new patients |
| Womencare PA | Past | Accepting new patients | |
| Andrew D Karen MD LLC | Obstetrics & Gynecology | Past | Accepting new patients |
| Planned Parenthood of Florida, Inc. | 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
4030 W Boy Scout Blvd
Ste 800
Tampa, FL 33607
Phone (813) 286-0333
5002 W Lemon St
Tampa, FL 33609
2818 W Virginia Ave
Tampa, FL 33607
Phone (813) 872-8551
2102 Trinity Oaks Blvd
#171
Trinity, FL 34655
Phone (727) 376-7734
Interoperability endpoints
- marybeth.lewis-boardman.1@2183.direct.athenahealth.com
- mary.beth.lewis-boardman.1@26576.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Gynecology Physician | 207VG0400X | ME93877 | FL | Yes |
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
Other providers in Leesburg, FL
- Level-Up Aprn, PLLC
- Michael S Levine
- David Matthew Levitt
- Camilla Levran
- David C Lew
- LHCG CLV, LLC
- David Richard Lichtinger
- Life-Line Medical Transportation Inc.
- Lifestream Behavioral Center Inc
- Lifestream Behavioral Center Inc
All providers in Leesburg, FL · Gynecology Physician in Florida
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 17, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.