Active NPI
Katherine Leslie Boyd, MD
- Dermatology Physician
- Vancouver, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- MD60546990
- Practice address
- 501 SE 172ND Ave
Suite 250
Vancouver, WA 98684-9542 - Phone
- (360) 882-2778
- Fax
- (360) 604-1719
- NPI assigned
- Jun 12, 2008
- Last updated
- Jun 8, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | 0101254341 | VA | |
| Dermatology Physician | 207N00000X | MD60546990 | WA | Primary |
| Dermatopathology Physician | 207ND0900X | MD60546990 | WA |
Addresses
Primary practice location
501 SE 172ND Ave
Suite 250
Vancouver, WA 98684-9542
Mailing address
PO Box 873010
Vancouver, WA 98687-3010
Phone (360) 882-2778
Other identifiers 14
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1437319423 | Medicaid | NC | |
| 499831 | Other | VA | ANTHEM BC/BS |
| 1437319423 | Other | VA | CIGNA |
| PAR | Other | VA | MULTIPLAN |
| 1437319423 | Other | VA | VIRGINIA PREMIER HEALTH PLAN |
| -005 | Other | VA | TRICARE/CHAMPUS |
| 1437319423 | Medicaid | VA | |
| PAR | Other | VA | VIRGINIA HEALTH NETWORK |
| 10114693 | Other | VA | OPTIMA HEALTH |
| 1437319423 | Other | VA | UNITED HEALTHCARE |
| PAR | Other | VA | USA MANAGED CARE |
| 1437319423 | Other | VA | COVENTRY NETWORK |
| PAR | Other | VA | CORVEL |
| PAR | Other | VA | AETNA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- George Washington University School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
700 NE 87TH Ave
Vancouver, WA 98664-1913
Phone (360) 882-2778
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Vancouver Clinic Inc PS | Current | Accepting new patients | |
| The Vancouver Clinic Inc PS | Dermatology | Current | Accepting new patients |
| The Vancouver Clinic Pharmacy | Past | Accepting new patients |
Locations
12019 NE 99th St
Ste 1730
Vancouver, WA 98682
501 SE 172nd Ave
Vancouver, WA 98684
501 SE 172nd Ave
Ste 250
Vancouver, WA 98684
700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500
Organizations & group practices 3
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.
-
dba The Vancouver Clinic
- Internal Medicine Physician
- Vancouver, WA
- NPI 1992759427
Dermatology
-
dba Salmon Creek 2 Ambulatory Surgery Center
- Ambulatory Surgical Clinic/Center
- Vancouver, WA
- NPI 1306556907
-
- Pharmacist
- Vancouver, WA
- NPI 1336365857
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Portland, OR
- NPI 1609824010
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1433721600000",
"number": "1437319423",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 873010",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986873010",
"telephone_number": "360-882-2778",
"fax_number": "360-604-1719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 SE 172ND AVE",
"address_2": "SUITE 250",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986849542",
"telephone_number": "360-882-2778",
"fax_number": "360-604-1719"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "KATHERINE",
"middle_name": "LESLIE",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-06-12",
"last_updated": "2015-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "VA",
"license": "0101254341",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "WA",
"license": "MD60546990",
"primary": true
},
{
"code": "207ND0900X",
"taxonomy_group": "",
"desc": "Dermatology, Dermatopathology",
"state": "WA",
"license": "MD60546990",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1437319423",
"state": "NC"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ANTHEM BC/BS",
"identifier": "499831",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "1437319423",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MULTIPLAN",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA PREMIER HEALTH PLAN",
"identifier": "1437319423",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TRICARE/CHAMPUS",
"identifier": "-005",
"state": "VA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1437319423",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VIRGINIA HEALTH NETWORK",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTIMA HEALTH",
"identifier": "10114693",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "1437319423",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "USA MANAGED CARE",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COVENTRY NETWORK",
"identifier": "1437319423",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CORVEL",
"identifier": "PAR",
"state": "VA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "PAR",
"state": "VA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2015; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.