Individual provider Active NPI

De'Asiah Nateerah Boyd

  • Physician Assistant
  • Fairfield, OH
National Provider Identifier
1295469773
Registry record updated Feb 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.007660RX Issued in OH
Practice address
2960 Mack Rd Ste 200
Fairfield, OH 45014-5300
Phone
(513) 421-3494
Fax
(513) 867-3241
NPI assigned
Jul 12, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X TC297 KY
Physician Assistant 363A00000X 50.007660RX OH Primary

Addresses

Primary practice location

2960 Mack Rd Ste 200
Fairfield, OH 45014-5300

Mailing address

2960 Mack Rd Ste 200
Fairfield, OH 45014-5300
Phone (513) 421-3494

Other practice location 1

1 Medical Village Dr
Edgewood, KY 41017-3403
Phone (513) 328-4249

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY, OH2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20221213000909 KY Practitioner - Physician Assistant 9436528544 Reassigns benefits to 1 organization
I20240228000172 OH Practitioner - Physician Assistant 9436528544 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

201 Old Bank Rd
Suite 103
Milford, OH 45150-2443
Phone (513) 624-2070

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
TC297KYMDPhysician Assistant
50.007660RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mercy Health Physicians Cincinnati Specialty Care LLC Physician Assistant CurrentSince Mar 10, 2024 Accepting new patients
Mercy Health Physicians Cincinnati Specialty Care LLC CurrentSince Mar 10, 2024 Accepting new patients
St Elizabeth Medical Center, Inc Physician Assistant CurrentSince Oct 3, 2022 Accepting new patients
St Elizabeth Medical Center, Inc CurrentSince Oct 3, 2022 Accepting new patients

Locations

1 Medical Village Dr
Edgewood, KY 41017
Phone (859) 301-2000

238 Barnes Rd
Williamstown, KY 41097
Phone (859) 292-4000

1701 Mercy Health Pl
Cincinnati, OH 45237
Phone (513) 952-5000

8000 5 Mile Rd
Ste 260
Cincinnati, OH 45230
Phone (513) 686-2663

2960 Mack Rd
Ste 200
Fairfield, OH 45014
Phone (513) 860-5200

201 Old Bank Rd
Ste 103
Milford, OH 45150
Phone (513) 248-0100

Interoperability endpoints

  • Direct secure messaging: dboyd2526674@direct.bsmhealth.org

Organizations & group practices 4

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 3

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": "1657584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707782400000",
    "number": "1295469773",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2960 MACK RD STE 200",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145300",
            "telephone_number": "513-421-3494",
            "fax_number": "513-867-3241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 MACK RD STE 200",
            "city": "FAIRFIELD",
            "state": "OH",
            "postal_code": "450145300",
            "telephone_number": "513-421-3494",
            "fax_number": "513-867-3241"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Medical Village Dr",
            "address_purpose": "LOCATION",
            "city": "Edgewood",
            "state": "KY",
            "postal_code": "410173403",
            "country_code": "US",
            "telephone_number": "513-328-4249",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYD",
        "first_name": "DE'ASIAH",
        "middle_name": "NATEERAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-12",
        "last_updated": "2024-02-13",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "KY",
            "license": "TC297",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.007660RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, OH

Sources for this page

Verify at the official NPI Registry.