Justin Boland, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

1429 Issued in NM

Practice address

2100 S Triviz Dr Ste G
Las Cruces, NM 88001-0601

Phone

(575) 556-1849

Fax

(575) 532-2030

NPI assigned

Jul 20, 2017

Last updated

Aug 11, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NM

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Las Cruces Physician Practices, LLCGroup PAC ID 7618974858, 107 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: justin.boland.1@19849.direct.athenahealth.com

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.

• Las Cruces Physician Practices, LLC

  dba NM Cardiovascualr Associates

  • Vascular Surgery Physician
  • Las Cruces, NM
  • NPI 1093947491
  Medicare reassignment Care Compare group NPD
• Las Cruces Physician Practices, LLC

  dba New Mexico Cardiac Care

  • Cardiovascular Disease Physician
  • Las Cruces, NM
  • NPI 1346586195
  NPD

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

{
    "created_epoch": "1500508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565481600000",
    "number": "1679096788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4577 NORTHWIND RD",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880074531",
            "telephone_number": "650-303-9102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 S TRIVIZ DR STE G",
            "city": "LAS CRUCES",
            "state": "NM",
            "postal_code": "880010601",
            "telephone_number": "575-556-1849",
            "fax_number": "575-532-2030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "JUSTIN",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-07-20",
        "last_updated": "2019-08-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "NM",
            "license": "1429",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Bodisch
• Body Bella
• Judith Anne Boehmer, LPCC
• Sunjung Bok
• Daubney M Boland, PHD
• Natalie M Bolanos, OT
• Ruben Bolanos
• Benjamin J. Boldt
• Jonathan Boldt, LPCC
• Savannah Bolyard

• Psychologist in Las Cruces, NM
• Providers in Las Cruces, NM by specialty
• Psychologist in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2019; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.