Active NPI
Thomas Raymond Boxleiter, M.D.
- Psychiatry Physician
- Dubuque, IA
National Provider Identifier
1619927431
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- 22625
- Practice address
- 200 Mercy Dr
Suite 201
Dubuque, IA 52001-7303 - Phone
- (563) 584-3500
- Fax
- (563) 584-3520
- NPI assigned
- May 11, 2006
- Last updated
- Nov 25, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 22625 | IA | Primary |
| Psychiatry Physician | 2084P0800X | 036-092993 | WI |
Addresses
Primary practice location
200 Mercy Dr
Suite 201
Dubuque, IA 52001-7303
Mailing address
1500 Associates Dr
Dubuque, IA 52002-2201
Phone (563) 584-4100
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0214312 | Medicaid | IA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 036-092993 | WI | MD | Psychiatry Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lloyd Callaway, Jr., M.D., S.C. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Specialist
- Galena, IL
- NPI 1649244427
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147305600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1259107200000",
"number": "1619927431",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1500 ASSOCIATES DR",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520022201",
"telephone_number": "563-584-4100",
"fax_number": "563-584-4110"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "200 MERCY DR",
"address_2": "SUITE 201",
"city": "DUBUQUE",
"state": "IA",
"postal_code": "520017303",
"telephone_number": "563-584-3500",
"fax_number": "563-584-3520"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOXLEITER",
"first_name": "THOMAS",
"middle_name": "RAYMOND",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-11",
"last_updated": "2009-11-25",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "IA",
"license": "22625",
"primary": true
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WI",
"license": "036-092993",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0214312",
"state": "IA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dubuque, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2009; 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.