Active NPI
Mark Brian Boas, OD
- Optometrist
- Exton, PA
National Provider Identifier
1437269487
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- OEG001120
- Practice address
- 577 W Uwchlan Ave
Exton, PA 19341-1563 - Phone
- (610) 363-2303
- NPI assigned
- Aug 30, 2006
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | OEG001120 | PA | Primary |
Addresses
Primary practice location
577 W Uwchlan Ave
Exton, PA 19341-1563
Mailing address
577 W Uwchlan Ave
Exton, PA 19341-1563
Phone (610) 363-2303
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 428694 | Other | PA | BLUE SHIELD |
| 2814726 | Other | PA | CIGNA |
| 51940 | Other | PA | AETNA HMO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| OEG001120 | PA | MD | Optometrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156896000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330473600000",
"number": "1437269487",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "577 W UWCHLAN AVE",
"city": "EXTON",
"state": "PA",
"postal_code": "193411563",
"telephone_number": "610-363-2303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "577 W UWCHLAN AVE",
"city": "EXTON",
"state": "PA",
"postal_code": "193411563",
"telephone_number": "610-363-2303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOAS",
"first_name": "MARK",
"middle_name": "BRIAN",
"name_prefix": "Dr.",
"credential": "OD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-30",
"last_updated": "2012-02-29",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "PA",
"license": "OEG001120",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE SHIELD",
"identifier": "428694",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "2814726",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA HMO",
"identifier": "51940",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Exton, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.