Individual provider Active NPI

Paul Michael Boylan, PHARM.D., BCPS

  • Pharmacist
  • Oklahoma City, OK
National Provider Identifier
1538694948
Registry record updated Aug 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
18861 Issued in OK
Practice address
1110 N Stonewall Ave
Oklahoma City, OK 73117-1200
Phone
(405) 271-6878
Fax
(405) 271-6430
NPI assigned
Apr 23, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RP449041 PA
Pharmacist 183500000X PS54925 FL
Pharmacist 183500000X 18861 OK Primary

Addresses

Primary practice location

1110 N Stonewall Ave
Oklahoma City, OK 73117-1200

Mailing address

1110 N Stonewall Ave # Cpb239
Oklahoma City, OK 73117-1200
Phone (405) 271-6878

Other practice location 1

241 NE 108th St
Miami, FL 33161-7050
Phone (305) 558-2500

Other practice location 2

18301 N Miami Ave
Miami, FL 33169-4564
Phone (305) 760-7495

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)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PS54925FLMDPharmacist
RP449041PAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Aurelio a. Ortiz, MD, LLC Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1492905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693440000000",
    "number": "1538694948",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 N STONEWALL AVE # CPB239",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171200",
            "telephone_number": "405-271-6878",
            "fax_number": "405-271-6430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1110 N STONEWALL AVE",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731171200",
            "telephone_number": "405-271-6878",
            "fax_number": "405-271-6430"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "241 NE 108th St",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331617050",
            "country_code": "US",
            "telephone_number": "305-558-2500",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "18301 N Miami Ave",
            "address_purpose": "LOCATION",
            "city": "Miami",
            "state": "FL",
            "postal_code": "331694564",
            "country_code": "US",
            "telephone_number": "305-760-7495",
            "fax_number": "305-760-7453",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYLAN",
        "first_name": "PAUL",
        "middle_name": "MICHAEL",
        "credential": "PHARM.D., BCPS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-04-23",
        "last_updated": "2023-08-31",
        "certification_date": "2020-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "PA",
            "license": "RP449041",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "FL",
            "license": "PS54925",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OK",
            "license": "18861",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2023; 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.