Evander A Boynton III, M.D.

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

ME-0089123 Issued in FL

Practice address

1125 Bartow Rd
Suite 101
Lakeland, FL 33801-5852

Phone

(863) 683-7171

Fax

(863) 687-0742

NPI assigned

Mar 8, 2006

Last updated

Aug 8, 2025By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Pathology

Education

University of South Carolina School of Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lakeland Pathologists, PAGroup PAC ID 3274428982, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lakeland Regional Medical Center Hospital, Lakeland, FL, CCN 100157

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

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.

• Lakeland Pathologists, PA

  • Anatomic Pathology & Clinical Pathology Physician
  • Lakeland, FL
  • NPI 1649220872
  Medicare reassignment Care Compare group NPD
• Micro Path Laboratories Inc

  • Clinical Medical Laboratory
  • Lakeland, FL
  • NPI 1932159118
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lakeland Regional Medical Center, Inc.

  dba Lakeland Regional Medical Center

  • General Acute Care Hospital
  • Lakeland, FL
  • NPI 1144228446
  Care Compare affiliation

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

{
    "created_epoch": "1141776000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1760459770",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 BARTOW RD",
            "address_2": "SUITE 101",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015852",
            "telephone_number": "863-683-7171",
            "fax_number": "863-687-0742"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 BARTOW RD",
            "address_2": "SUITE 101",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015852",
            "telephone_number": "863-683-7171",
            "fax_number": "863-687-0742"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYNTON",
        "first_name": "EVANDER",
        "middle_name": "A",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-08",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "FL",
            "license": "ME-0089123",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "269082900",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Lowell Bowers, MD
• Sujeiry Bowles, APRN
• Vanessa Aye Bowne, SLP
• Mark Austin Bowyer, MD
• Deborah Beall Boynton
• Angelina Boyzo
• Suzanne Brabant, LCSW
• Domanic Brack
• Terence Patrick Braden III, D.O.
• Glendon Wayne Bradley, PMHNP

• Anatomic Pathology & Clinical Pathology Physician in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Anatomic Pathology & Clinical Pathology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; 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.