NPIMap

Individual provider Active NPI

Jacob Daniel Boyer, PA-C

  • Physician Assistant
  • Grinnell, IA
National Provider Identifier
1306193248
Registry record updated Aug 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
002319 Issued in IA
Practice address
210 4TH Ave
Grinnell, IA 50112-1898
Phone
(641) 236-2500
NPI assigned
Aug 9, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 002319 IA Primary

Addresses

Primary practice location

210 4TH Ave
Grinnell, IA 50112-1898

Mailing address

210 4TH Ave
Grinnell, IA 50112-1898
Phone (641) 236-2500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121110000139 IA Practitioner - Physician Assistant 8921259466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grinnell Regional Medical CenterGroup PAC ID 0446153662, 98 clinicians

Practice addresses (Care Compare)

202 4TH Ave
FL 2
Grinnell, IA 50112-1898
Phone (641) 236-2925

210 4TH Ave
Grinnell, IA 50112-1898
Phone (641) 236-7511

Hospital & facility affiliations

  • Unitypoint at Home Home health agency, Urbandale, IA, CCN 167148
  • Grinnell Regional Medical Center Hospital, Grinnell, IA, CCN 160147
  • St Francis Manor Nursing home, Grinnell, IA, CCN 165480
  • Mayflower Home Nursing home, Grinnell, IA, CCN 165481

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
002319IAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grinnell Regional Medical Center Physician Assistant CurrentSince Jan 1, 2015 Accepting new patients
St Luke'S Methodist Hospital Current Accepting new patients
Floyd County Memorial Hospital Commission Past Accepting new patients
Grinnell Regional Medical Center Past Accepting new patients

Locations

210 4th Ave
Grinnell, IA 50112
Phone (641) 236-2055

202 4th Ave
Ste 300
Grinnell, IA 50112
Phone (641) 236-2323

Interoperability endpoints

  • Direct secure messaging: jboyer672008@direct.unitypoint.org
  • Direct secure messaging: jacobboyer@grmc.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Grinnell Regional Medical CenterGrinnell, IA, CCN 160147 Hospital Corporate Director Jan 22, 2020
Grinnell Regional Medical CenterGrinnell, IA, CCN 16U147 Hospital Corporate Director Jan 22, 2020
Unitypoint Health - GrinnellGrinnell, IA, CCN 168647 Rural health clinic Corporate Director Jan 22, 2020
Unitypoint Health - Grinnell Montezuma Medical ClinicMontezuma, IA, CCN 168659 Rural health clinic Corporate Director Jan 22, 2020

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

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 4

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": "1344470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1344470400000",
    "number": "1306193248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 4TH AVE",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501121898",
            "telephone_number": "641-236-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 4TH AVE",
            "city": "GRINNELL",
            "state": "IA",
            "postal_code": "501121898",
            "telephone_number": "641-236-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYER",
        "first_name": "JACOB",
        "middle_name": "DANIEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-08-09",
        "last_updated": "2012-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "IA",
            "license": "002319",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grinnell, IA

Sources for this page

Verify at the official NPI Registry.