Active NPI
Wayne Rodney Boyd, MD
- Diagnostic Radiology Physician
- San Bernardino, CA
National Provider Identifier
1871591727
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- A21591
- Practice address
- 399 E 21St St
San Bernardino, CA 92404-4815 - Phone
- (909) 882-2266
- Fax
- (909) 881-7593
- NPI assigned
- Jul 13, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | A21591 | CA | Primary |
Addresses
Primary practice location
399 E 21St St
San Bernardino, CA 92404-4815
Mailing address
399 E 21St St
San Bernardino, CA 92404-4815
Phone (909) 882-2266
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00A21591 | Medicaid | CA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: Yes
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A21591 | CA | MD | Diagnostic Radiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Faculty Physicians and Surgeons of Llusm | Current | Accepting new patients |
Locations
File Number 54701
Los Angeles, CA 90074
Phone (909) 651-4300
Interoperability endpoints
- wboyd335141@direct.llu.edu
Organizations & group practices 1
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121212800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515974400000",
"number": "1871591727",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "399 E 21ST ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924044815",
"telephone_number": "909-882-2266",
"fax_number": "909-881-7593"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "399 E 21ST ST",
"city": "SAN BERNARDINO",
"state": "CA",
"postal_code": "924044815",
"telephone_number": "909-882-2266",
"fax_number": "909-881-7593"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "WAYNE",
"middle_name": "RODNEY",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-07-13",
"last_updated": "2018-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "CA",
"license": "A21591",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00A21591",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in San Bernardino, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2018; 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.