Individual provider Active NPI

Michelle Boyer, PA-C

  • Physician Assistant
  • Flagstaff, AZ
National Provider Identifier
1770519183
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2662 Issued in AZ
Practice address
1485 N Turquoise Dr
Suite 200
Flagstaff, AZ 86001-1398
Phone
(928) 774-7757
Fax
(928) 226-3071
NPI assigned
Jun 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2662 AZ Primary

Addresses

Primary practice location

1485 N Turquoise Dr
Suite 200
Flagstaff, AZ 86001-1398

Mailing address

PO Box 3630
Flagstaff, AZ 86003-3630
Phone (928) 522-9879

Other practice location 1

2920 N 4th St
Flagstaff, AZ 86004-1816
Phone (928) 522-4000

Other identifiers 1

IdentifierTypeStateIssuer
725278MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20231208001041 LA Practitioner - Physician Assistant 0941198121 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

231 Windermere Blvd
Alexandria, LA 71303-3538
Phone (318) 487-2020

Merit-based Incentive Payment System (MIPS)

Final score
87.92 of 100Reported as group
Quality
78.04
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2662AZMDDentist

Practice roles

OrganizationSpecialtyStatusNew patients
Alexandria Eye and Laser Center, LLC CurrentSince Nov 1, 2023 Accepting new patients
Alexandria Eye and Laser Center, LLC CurrentSince Nov 1, 2023 Accepting new patients
Flagstaff Medical Center Past Accepting new patients

Locations

231 Windermere Blvd
Alexandria, LA 71303
Phone (318) 445-7770

108 6th Ave
Kinder, LA 70648
Phone (337) 738-2527

1008 S 6th St
Leesville, LA 71446
Phone (337) 392-1994

65 Medical Park Blvd
Pineville, LA 71360
Phone (318) 445-6363

Interoperability endpoints

  • Direct secure messaging: mboyer2@laeye.emadirect.md

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1151193600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1770519183",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3630",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860033630",
            "telephone_number": "928-522-9879"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 N TURQUOISE DR",
            "address_2": "SUITE 200",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011398",
            "telephone_number": "928-774-7757",
            "fax_number": "928-226-3071"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2920 N 4th St",
            "address_purpose": "LOCATION",
            "city": "Flagstaff",
            "state": "AZ",
            "postal_code": "860041816",
            "country_code": "US",
            "telephone_number": "928-522-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOYER",
        "first_name": "MICHELLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-25",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "2662",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "725278",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Flagstaff, AZ

Sources for this page

Verify at the official NPI Registry.