Individual provider Active NPI

Brandon Taylor Jacobs Boyd, DO

  • Internal Medicine Physician
  • Louisville, KY
National Provider Identifier
1376117762
Registry record updated Jul 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
05870 Issued in KY
Practice address
11701 Bluegrass Pkwy Ste 200
Louisville, KY 40299-2302
Phone
(502) 245-4168
NPI assigned
May 19, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Internal Medicine Physician 207R00000X 05870 KY Primary

Addresses

Primary practice location

11701 Bluegrass Pkwy Ste 200
Louisville, KY 40299-2302

Mailing address

5200 Commerce Crossings Dr
Louisville, KY 40229-2182
Phone (502) 245-4168

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240916002900 KY Practitioner - Internal Medicine 3476954728 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Lake Erie College of Osteopathic Medicine, Erie, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

11701 Bluegrass Pkwy
Suite 200
Louisville, KY 40299-2302
Phone (502) 245-4168

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Aug 1, 2024 Accepting new patients
Baptist Health Medical Group Inc Internal Medicine CurrentSince Aug 1, 2024 Accepting new patients

Locations

5200 Commerce Crossings Dr
Louisville, KY 40229
Phone (502) 253-4900

11701 Bluegrass Pkwy
#200
Louisville, KY 40299
Phone (502) 245-4168

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

Organizations & group practices 2

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 2

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": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721952000000",
    "number": "1376117762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 COMMERCE CROSSINGS DR",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402292182",
            "telephone_number": "502-245-4168"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11701 BLUEGRASS PKWY STE 200",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402992302",
            "telephone_number": "502-245-4168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYD",
        "first_name": "BRANDON",
        "middle_name": "TAYLOR JACOBS",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-19",
        "last_updated": "2024-07-26",
        "certification_date": "2024-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "KY",
            "license": "05870",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, KY

Sources for this page

Verify at the official NPI Registry.