Individual provider Active NPI

Thomas V Boran, MD

  • Otolaryngology Physician
  • Pottsville, PA
National Provider Identifier
1497748685
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD030208E Issued in PA
Practice address
100 Schuylkill Medical PLZ
Suite 205
Pottsville, PA 17901-3663
Phone
(570) 621-5010
Fax
(570) 628-2525
NPI assigned
Aug 24, 2005
Last updated
Mar 18, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X MD030208E PA Primary

Addresses

Primary practice location

100 Schuylkill Medical PLZ
Suite 205
Pottsville, PA 17901-3663

Mailing address

100 Schuylkill Medical PLZ
Suite 205
Pottsville, PA 17901-3663
Phone (570) 621-5010

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
Credentials
Doctor of Medicine

Organizations & group practices 1

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": "1124841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1497748685",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SCHUYLKILL MEDICAL PLZ",
            "address_2": "SUITE 205",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013663",
            "telephone_number": "570-621-5010",
            "fax_number": "570-628-2525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 SCHUYLKILL MEDICAL PLZ",
            "address_2": "SUITE 205",
            "city": "POTTSVILLE",
            "state": "PA",
            "postal_code": "179013663",
            "telephone_number": "570-621-5010",
            "fax_number": "570-628-2525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORAN",
        "first_name": "THOMAS",
        "middle_name": "V",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-24",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "PA",
            "license": "MD030208E",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pottsville, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.