NPIMap

Individual provider Active NPI

Kohldon Carter Boydston, MD

  • Urology Physician
  • Wauwatosa, WI
National Provider Identifier
1518320100
Registry record updated Jul 31, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
76733 Issued in WI
Practice address
2600 N Mayfair Rd Ste 545
Wauwatosa, WI 53226-1306
Phone
(414) 476-0430
NPI assigned
Mar 31, 2016
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 31, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 76733 WI Primary

Addresses

Primary practice location

2600 N Mayfair Rd Ste 545
Wauwatosa, WI 53226-1306

Mailing address

2600 N Mayfair Rd Ste 545
Wauwatosa, WI 53226-1306
Phone (414) 476-0430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220315001160 WI Practitioner - Urology 5294028809 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Rush Medical College of Rush University, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Metropolitan Urology Group, SCGroup PAC ID 6002703840, 4 clinicians

Practice addresses (Care Compare)

2600 N Mayfair Rd
Suite 545
Wauwatosa, WI 53226-1306
Phone (414) 476-0430

3811 Spring St
Suite 302
Mount Pleasant, WI 53405-1667
Phone (262) 687-8202

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection12

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
76733WIMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ascension Medical Group-Southeast Wisconsin Inc CurrentSince Jun 9, 2022 Accepting new patients
Ascension Medical Group-Southeast Wisconsin Inc Urology CurrentSince Jun 9, 2022 Accepting new patients
Metropolitan Urology Group, SC Urology CurrentSince May 6, 2022 Accepting new patients
Ascension All Saints Hospital, Inc Past Accepting new patients

Locations

13950 W Capitol Dr
Brookfield, WI 53005
Phone (414) 302-5400

3811 Spring St
Ste 302
Mount Pleasant, WI 53405
Phone (262) 687-8202

2600 N Mayfair Rd
Ste 545
Wauwatosa, WI 53226
Phone (414) 476-0430

201 N Mayfair Rd
Fl 2
Wauwatosa, WI 53226
Phone (414) 771-8228

2600 N Mayfair Rd
Ste 580
Wauwatosa, WI 53226
Phone (414) 732-2715

Interoperability endpoints

  • Direct secure messaging: kohldonboydston@metro.medalliesdirect.net

Organizations & group practices 4

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 6

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": "1459382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785456000000",
    "number": "1518320100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD STE 545",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261306",
            "telephone_number": "414-476-0430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 N MAYFAIR RD STE 545",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532261306",
            "telephone_number": "414-476-0430"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYDSTON",
        "first_name": "KOHLDON",
        "middle_name": "CARTER",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-03-31",
        "last_updated": "2026-07-31",
        "certification_date": "2026-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "WI",
            "license": "76733",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

Verify at the official NPI Registry.