Individual provider Active NPI

Travis W Boevin, PHARMD

  • Pharmacist
  • Cicero, NY
National Provider Identifier
1740524834
Registry record updated Nov 15, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
048651 Issued in NY
Practice address
8221 Hoyt Farm
Cicero, NY 13039-8931
Phone
(315) 699-4949
NPI assigned
Nov 15, 2012
Last updated
Nov 15, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 15, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 048651 NY Primary

Addresses

Primary practice location

8221 Hoyt Farm
Cicero, NY 13039-8931

Mailing address

8221 Hoyt Farm
Cicero, NY 13039-8931

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
048651NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352937600000",
    "number": "1740524834",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8221 HOYT FARM",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130398931"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8221 HOYT FARM",
            "city": "CICERO",
            "state": "NY",
            "postal_code": "130398931",
            "telephone_number": "315-699-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEVIN",
        "first_name": "TRAVIS",
        "middle_name": "W",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "048651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cicero, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; 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.