Active NPI
Jacob Tyler Boyd, MD, PHD
- Student in an Organized Health Care Education/Training Program
- Aurora, CO
National Provider Identifier
1376123364
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- License
- TL.0008650
- Practice address
- 12631 E. 17TH Ave. Ms B205
Room 3001
Aurora, CO 80045 - Phone
- (303) 724-1965
- NPI assigned
- Apr 13, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | TL.0008650 | CO | Primary |
Addresses
Primary practice location
12631 E. 17TH Ave. Ms B205
Room 3001
Aurora, CO 80045
Mailing address
12631 E. 17TH Ave. Ms B205
Room 3001
Aurora, CO 80045
Phone (303) 724-1965
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine, Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| TL.0008650 | CO | MD | Student in an Organized Health Care Education/Training Program |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children's Hospital Colorado | Current | Accepting new patients | |
| Taos Health Systems, Inc., Holy Cross Hospital | Past | Accepting new patients |
Interoperability endpoints
- jboyd234664@direct.childrenscolorado.org
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.
-
- Clinical Social Worker
- Aurora, CO
- NPI 1174282776
-
- Critical Access Hospital
- Taos, NM
- NPI 1902338049
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618272000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618272000000",
"number": "1376123364",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "12631 E. 17TH AVE. MS B205",
"address_2": "ROOM 3001",
"city": "AURORA",
"state": "CO",
"postal_code": "80045",
"telephone_number": "303-724-1965"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12631 E. 17TH AVE. MS B205",
"address_2": "ROOM 3001",
"city": "AURORA",
"state": "CO",
"postal_code": "80045",
"telephone_number": "303-724-1965"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "JACOB",
"middle_name": "TYLER",
"name_prefix": "Dr.",
"credential": "MD, PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-04-13",
"last_updated": "2021-04-13",
"certification_date": "2021-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "CO",
"license": "TL.0008650",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Aurora, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.