Mary J Boylan, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

38670 Issued in MN

Practice address

920 E 1St St
Ste 303
Duluth, MN 55805-2201

Phone

(218) 249-6050

Fax

(218) 249-6055

NPI assigned

May 16, 2006

Last updated

Aug 7, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MN, CO, NH3 enrollments

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 3

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• St. Luke's Hospital of Duluth

  dba Aspirus St Lukes Hospital Inpatient Rehab

  • Rehabilitation Hospital Unit
  • Duluth, MN
  • NPI 1902845068
  Medicare reassignment NPD
• Intermountain Medical Group Grand Junction, LLC

  • Orthopaedic Surgery Physician
  • Grand Junction, CO
  • NPI 1356765556

  Thoracic Surgery (Cardiothoracic Vascular Surgery)

  Medicare reassignment NPD
• St. Luke's Hospital of Duluth

  dba Aspirus Palliative Medicine - Minnesota

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Duluth, MN
  • NPI 1073480968
  NPD
• St. Luke's Hospital of Duluth

  dba Aspirus St Lukes Clinic Duluth Cardiothoracic Surgery

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Duluth, MN
  • NPI 1912951609
  NPD
• Intermountain Medical Group Grand Junction, LLC

  dba SCL Health Medical Group - Physical Medicine & Rehab Delta

  • Physical Medicine & Rehabilitation Physician
  • Delta, CO
  • NPI 1427712967
  NPD
• Intermountain Medical Group Grand Junction, LLC

  dba DME - Wellington Neurosurgery Clinic

  • Durable Medical Equipment & Medical Supplies
  • Grand Junction, CO
  • NPI 1609737618
  NPD

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722988800000",
    "number": "1851343131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 E 1ST ST",
            "address_2": "STE 303",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052201",
            "telephone_number": "218-249-6050",
            "fax_number": "218-249-6055"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 E 1ST ST",
            "address_2": "STE 303",
            "city": "DULUTH",
            "state": "MN",
            "postal_code": "558052201",
            "telephone_number": "218-249-6050",
            "fax_number": "218-249-6055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOYLAN",
        "first_name": "MARY",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2024-08-07",
        "certification_date": "2024-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "MN",
            "license": "38670",
            "primary": true
        },
        {
            "code": "208G00000X",
            "taxonomy_group": "",
            "desc": "Thoracic Surgery (Cardiothoracic Vascular Surgery)",
            "state": "NH",
            "license": "33516",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201716400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gail E Bowdish, MD
• Christine Elizabeth Kanani Bowerman, PHD, LP
• Dan Lee Bowman, LICSW
• Daniel Reed Bowman, M.D.
• Mark William Boyce
• Emily Ann Boyle
• Jennifer Renaud Boyle, MD
• Kathryn Terese Boyle
• Randy A. Braaten, M.D.
• Anna M Brabec, CRNA

• Surgery Physician in Duluth, MN
• Providers in Duluth, MN by specialty
• Surgery Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.