Allan James Boyum, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

15643 Issued in MN

Practice address

26242 Stillwater Cir
Punta Gorda, FL 33955-4731

Phone

(612) 423-2202

NPI assigned

Jun 9, 2006

Last updated

Oct 2, 2018By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1149811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1538438400000",
    "number": "1528009735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26242 STILLWATER CIR",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339554731",
            "telephone_number": "612-423-1127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26242 STILLWATER CIR",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339554731",
            "telephone_number": "612-423-2202"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Veterans Dr",
            "address_purpose": "LOCATION",
            "city": "Minneapolis",
            "state": "MN",
            "postal_code": "554172309",
            "country_code": "US",
            "telephone_number": "612-467-1100",
            "fax_number": "612-467-1913",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYUM",
        "first_name": "ALLAN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-09",
        "last_updated": "2018-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "15643",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "426772900",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kiersta Borrego, DO
• Lisa M Boucher
• Gisela Belen Bouvier, MBA, RDN, LDN
• Victoria Catherine Bowman, PA-C
• William Patrick Boyan Sr., M.D.
• Scott Allan Bradley Jr., PT, DPT
• Aileen Brandt
• Beatrice Braswell
• John Paul Braut, D.O.
• Marci Starr Brennan, L.M.T.

• Internal Medicine Physician in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2018; 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.

Verify at the official NPI Registry.