Individual provider Active NPI

Alexis C Boice, PA-C

  • Physician Assistant
  • Philadelphia, PA
National Provider Identifier
1609153444
Registry record updated Jul 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA055290 Issued in PA
Practice address
333 Cottman Ave
Philadelphia, PA 19111
Phone
(215) 214-3943
NPI assigned
Nov 8, 2011
Last updated
Jul 18, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X MA055290 PA Primary

Addresses

Primary practice location

333 Cottman Ave
Philadelphia, PA 19111

Mailing address

333 Cottman Ave
Philadelphia, PA 19111-2434
Phone (215) 214-3943

Other practice location 1

380 Oxford Valley Rd
Langhorne, PA 19047-8304
Phone (215) 949-5260

Other practice location 2

10800 Knights Rd
Philadelphia, PA 19114-4200
Phone (215) 612-4963

Other practice location 3

4900 Frankford Ave
Philadelphia, PA 19124-2618
Phone (215) 831-2086

Other identifiers 1

IdentifierTypeStateIssuer
1609153444MedicaidPA

Other names 1

  • Alexis C Madrack Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120103000512 PA Practitioner - Physician Assistant 9830365428 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aria Health Physician ServicesGroup PAC ID 3577467018, 456 clinicians

Practice addresses (Care Compare)

380 N Oxford Valley Rd
Langhorne, PA 19047-8304
Phone (215) 750-6566

380 Oxford Valley Rd
Langhorne, PA 19047-8304

3998 Red Lion Rd
Philadelphia, PA 19114-1445
Phone (215) 992-6002

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA055290PAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Aria Health Physician Services CurrentSince Jan 28, 2019 Accepting new patients
Aria Health Physician Services Physical Medicine & Rehab CurrentSince Jan 28, 2019 Accepting new patients

Locations

380 N Oxford Valley Rd
Langhorne, PA 19047
Phone (215) 949-5000

10800 Knights Rd
Philadelphia, PA 19114
Phone (215) 612-2610

3998 Red Lion Rd
Philadelphia, PA 19114
Phone (215) 612-4060

4900 Frankford Ave
Philadelphia, PA 19124
Phone (215) 612-2610

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.

Hospital & facility affiliations 1

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": "1320710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1531872000000",
    "number": "1609153444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191112434",
            "telephone_number": "215-214-3943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 COTTMAN AVE",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "19111",
            "telephone_number": "215-214-3943"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 Oxford Valley Rd",
            "address_purpose": "LOCATION",
            "city": "Langhorne",
            "state": "PA",
            "postal_code": "190478304",
            "country_code": "US",
            "telephone_number": "215-949-5260",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10800 Knights Rd",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191144200",
            "country_code": "US",
            "telephone_number": "215-612-4963",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4900 Frankford Ave",
            "address_purpose": "LOCATION",
            "city": "Philadelphia",
            "state": "PA",
            "postal_code": "191242618",
            "country_code": "US",
            "telephone_number": "215-831-2086",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOICE",
        "first_name": "ALEXIS",
        "middle_name": "C",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-08",
        "last_updated": "2018-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055290",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1609153444",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ALEXIS",
            "last_name": "MADRACK",
            "middle_name": "C",
            "credential": "PA-C",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Philadelphia, PA

Sources for this page

Verify at the official NPI Registry.