Active NPI
Michael Andrew Boatwright, DO
- Infectious Disease Physician
- Portsmouth, VA
National Provider Identifier
1629576558
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Infectious Disease Physician
- License
- 0102205744
- Practice address
- 620 John Paul Jones Cir
Portsmouth, VA 23708-2111 - Phone
- (757) 953-5000
- NPI assigned
- Jan 25, 2018
- Last updated
- Jul 26, 2023
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 0102205744 | VA | |
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Infectious Disease Physician | 207RI0200X | 0102205744 | VA | Primary |
Addresses
Primary practice location
620 John Paul Jones Cir
Portsmouth, VA 23708-2111
Mailing address
620 John Paul Jones Cir
Infectious Diseases Clinic BLDG 3, Floor 1
Portsmouth, VA 23708-2111
Phone (757) 953-5000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in VA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20191205000227 | VA | Order and Referring Only - Internal Medicine | 3173956158 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516838400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1690329600000",
"number": "1629576558",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"address_2": "INFECTIOUS DISEASES CLINIC BLDG 3, FLOOR 1",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "620 JOHN PAUL JONES CIR",
"city": "PORTSMOUTH",
"state": "VA",
"postal_code": "237082111",
"telephone_number": "757-953-5000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOATWRIGHT",
"first_name": "MICHAEL",
"middle_name": "ANDREW",
"name_prefix": "Dr.",
"credential": "DO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-01-25",
"last_updated": "2023-07-26",
"certification_date": "2023-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "VA",
"license": "0102205744",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": false
},
{
"code": "207RI0200X",
"taxonomy_group": "",
"desc": "Internal Medicine, Infectious Disease",
"state": "VA",
"license": "0102205744",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portsmouth, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2023; 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.