Jay Boardman, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

7273 Issued in AZ

Practice address

13755 N Litchfield Rd Ste 105
Surprise, AZ 85379-4288

Phone

(623) 322-5900

NPI assigned

Sep 14, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Cep America- Arizona, PC

  • Emergency Medicine Physician
  • Chandler, AZ
  • NPI 1780202804
  Medicare reassignment
• Emergency Professional Services PC

  • Emergency Medicine Physician
  • Phoenix, AZ
  • NPI 1518984210
  Medicare reassignment
• Tec Emergency Physicians of Arizona, LLC

  • Emergency Care Clinic/Center
  • Gilbert, AZ
  • NPI 1245772870
  Medicare reassignment
• Cep America-Arizona, PC

  • Emergency Medicine Physician
  • Sun City, AZ
  • NPI 1306210224
  NPD
• Emergency Professional Services PC

  • Emergency Medicine Physician
  • Apache Junction, AZ
  • NPI 1205273406

  Physician Assistant

  NPD
• 4C Medical Group PLC

  • Urgent Care Clinic/Center
  • Carefree, AZ
  • NPI 1669916607
  NPD (past)

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

{
    "created_epoch": "1536883200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684713600000",
    "number": "1659854677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14109 N 83RD AVE APT 329",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853814779",
            "telephone_number": "469-693-2144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13755 N LITCHFIELD RD STE 105",
            "city": "SURPRISE",
            "state": "AZ",
            "postal_code": "853794288",
            "telephone_number": "623-322-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOARDMAN",
        "first_name": "JAY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-09-14",
        "last_updated": "2023-05-22",
        "certification_date": "2023-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "7273",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Blue Mountain Developmental Programs, LLC
• Blue Palm Medical
• Blue Sprig Pediatrics, Inc
• Keimonte Lemar Blueford Sr., MT
• Sumer Lynette Blum, SLPA
• Kellie Bobadilla, ST
• Bobbi-Jo'S Wellness for Life, LLC
• Lauren E Bock, COTA/L
• Abiyah Chayah Boehnlein
• Patricia R Bogaard, O.D.

• Physician Assistant in Surprise, AZ
• Providers in Surprise, AZ by specialty
• Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 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.

Verify at the official NPI Registry.