William Patrick Boyan Sr., M.D.

Primary specialty

Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X

License

25MA04549300 Issued in NJ

Practice address

25006 Purple Emperor Way
Punta Gorda, FL 33955-6220

Phone

(732) 600-0865

NPI assigned

Sep 14, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

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.

• Shore Health Group, PC

  • Internal Medicine Physician
  • Ocean, NJ
  • NPI 1902944416

  Geriatric Medicine

  NPD (past)

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

{
    "created_epoch": "1126656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651708800000",
    "number": "1679568877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25006 PURPLE EMPEROR WAY",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339556220",
            "telephone_number": "732-600-0865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25006 PURPLE EMPEROR WAY",
            "city": "PUNTA GORDA",
            "state": "FL",
            "postal_code": "339556220",
            "telephone_number": "732-600-0865"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYAN",
        "first_name": "WILLIAM",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-14",
        "last_updated": "2022-05-05",
        "certification_date": "2022-05-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NJ",
            "license": "25MA04549300",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4807006",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Booth, RN
• Kiersta Borrego, DO
• Lisa M Boucher
• Gisela Belen Bouvier, MBA, RDN, LDN
• Victoria Catherine Bowman, PA-C
• Allan James Boyum, M.D.
• Aileen Brandt
• Beatrice Braswell
• John Paul Braut, D.O.
• Marci Starr Brennan, L.M.T.

• Geriatric Medicine (Internal Medicine) Physician in Punta Gorda, FL
• Providers in Punta Gorda, FL by specialty
• Geriatric Medicine (Internal Medicine) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.