Individual provider Active NPI

Roger Wayne Boatwright, M.D.

  • General Practice Physician
  • Lancaster, PA
National Provider Identifier
1366656712
Registry record updated Nov 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
MD440992 Issued in PA
Practice address
100 Abbeyville Rd
Lancaster, PA 17603-4604
Phone
(301) 722-0484
Fax
(833) 903-0130
NPI assigned
May 9, 2007
Last updated
Nov 4, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 4, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 0101242423 VA
Obstetrics & Gynecology Physician 207V00000X MD440992 PA
General Practice Physician 208D00000X MD440992 PA Primary

Addresses

Primary practice location

100 Abbeyville Rd
Lancaster, PA 17603-4604

Mailing address

157 Baltimore St Ste 104
Cumberland, MD 21502-2472
Phone (301) 722-0484

Other identifiers 1

IdentifierTypeStateIssuer
1366656712MedicaidVA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
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
I20110121000337 PA Practitioner - General PracticePractitioner - Obstetrics/Gynecology 5890867030 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Novus Pain Management,PC CurrentSince Dec 1, 2025 Accepting new patients
Memorial Enterprises Inc Past Accepting new patients
Pain Medicine of York, LLC PastSince Aug 1, 2015 Accepting new patients
Novus Pain Management - Maryland, LLC Past Accepting new patients

Locations

157 Baltimore St
Ste 104
Cumberland, MD 21502

2781 Luther Dr
Chambersburg, PA 17202
Phone (717) 261-1251

3430 Huntingdon Pike
Huntingdon Vy, PA 19006
Phone (215) 938-7171

100 Abbeyville Rd
Lancaster, PA 17603
Phone (717) 397-4261

900 Tuck St
Lebanon, PA 17042
Phone (717) 273-8595

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, 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": "1178668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762214400000",
    "number": "1366656712",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "157 BALTIMORE ST STE 104",
            "city": "CUMBERLAND",
            "state": "MD",
            "postal_code": "215022472",
            "telephone_number": "301-722-0484",
            "fax_number": "833-903-0130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 ABBEYVILLE RD",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176034604",
            "telephone_number": "301-722-0484",
            "fax_number": "833-903-0130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOATWRIGHT",
        "first_name": "ROGER",
        "middle_name": "WAYNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-09",
        "last_updated": "2025-11-04",
        "certification_date": "2025-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "VA",
            "license": "0101242423",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "PA",
            "license": "MD440992",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "PA",
            "license": "MD440992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366656712",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lancaster, PA

Sources for this page

Verify at the official NPI Registry.