Active NPI
Richard Anthony Boada, M.D.
- Pediatrics Physician
- Jeffersonville, IN
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatrics Physician
- License
- 01050219A
- Practice address
- 3118 E 10TH St Ste B
Jeffersonville, IN 47130-5904 - Phone
- (812) 285-4585
- Fax
- (812) 284-2798
- NPI assigned
- Oct 25, 2006
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatrics Physician | 208000000X | 01050219A | IN | Primary |
| Pediatrics Physician | 208000000X | 32419 | KY |
Addresses
Primary practice location
3118 E 10TH St Ste B
Jeffersonville, IN 47130-5904
Mailing address
PO Box 776879
Chicago, IL 60677-6879
Phone (502) 588-9490
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| IN4465001 | Other | IN | MEDICARE |
| 200209820 | Medicaid | IN | |
| 64324197 | Medicaid | KY |
Electronic endpoints 2
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | rboada56720@direct.nortonhealthcare.org | ||
| FHIR URL | https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN, KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 2
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 01050219A | IN | MD | Pediatrics Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Norton Children'S Medical Group, LLC | Current | Accepting new patients | |
| Community Medical Associates, Inc. | Pediatrics | Current | Accepting new patients |
| Norton Children'S Medical Group, LLC | Current | Accepting new patients | |
| Community Medical Associates, Inc. | Current | Accepting new patients | |
| Norton Children'S Medical Group, LLC | Current | Accepting new patients | |
| Community Medical Associates, Inc. | Current | Accepting new patients | |
| Norton Childrens Medical Group, LLC | Pediatrics | Current | Accepting new patients |
| Community Medical Associates, Inc. | Pediatrics | Past | Accepting new patients |
Locations
2051 Clevidence Blvd
Ste B
Clarksville, IN 47129
Phone (502) 629-2030
2051 Clevidence Blvd
Clarksville, IN 47129
Phone (812) 280-6650
3118 E 10th St
Ste B
Jeffersonvlle, IN 47130
Phone (812) 282-6979
1373 E State Road 62
#6F
Madison, IN 47250
Phone (502) 629-7181
601 S Floyd St
Ste 604
Louisville, KY 40202
Phone (502) 559-1670
825 Barret Ave
Louisville, KY 40204
Phone (502) 272-5165
Interoperability endpoints
- rboada56720@direct.nortonhealthcare.org
Organizations & group practices 8
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.
-
- Multi-Specialty Clinic/Center
- Louisville, KY
- NPI 1306983762
-
- Internal Medicine Physician
- Louisville, KY
- NPI 1588614994
IN, Pediatrics
-
- Psychiatry Physician
- Louisville, KY
- NPI 1457999096
-
- Internal Medicine Physician
- Louisville, KY
- NPI 1881192409
-
- Pediatric Surgery Physician
- Louisville, KY
- NPI 1306487764
-
- Pediatric Radiology Physician
- Louisville, KY
- NPI 1659913812
-
- Neurological Surgery Physician
- Louisville, KY
- NPI 1922288760
Pediatrics
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161734400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1663718400000",
"number": "1891870218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 776879",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606776879",
"telephone_number": "502-588-9490",
"fax_number": "502-272-5116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3118 E 10TH ST STE B",
"city": "JEFFERSONVILLE",
"state": "IN",
"postal_code": "471305904",
"telephone_number": "812-285-4585",
"fax_number": "812-284-2798"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOADA",
"first_name": "RICHARD",
"middle_name": "ANTHONY",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-25",
"last_updated": "2022-09-21",
"certification_date": "2022-09-21",
"status": "A"
},
"taxonomies": [
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "IN",
"license": "01050219A",
"primary": true
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "KY",
"license": "32419",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "IN4465001",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "200209820",
"state": "IN"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64324197",
"state": "KY"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "rboada56720@direct.nortonhealthcare.org",
"affiliation": "N",
"address_1": "3118 E 10th St",
"address_2": "Suite B",
"city": "Jeffersonville",
"state": "IN",
"country_code": "US",
"postal_code": "471305904",
"country_name": "United States",
"address_type": "DOM"
},
{
"endpointType": "FHIR",
"endpointTypeDescription": "FHIR URL",
"endpoint": "https://epicsoap.nortonhealthcare.org/FHIRPRD/api/FHIR/DSTU2/",
"affiliation": "N",
"address_1": "3118 E 10th St",
"address_2": "Suite B",
"city": "Jeffersonville",
"state": "IN",
"country_code": "US",
"postal_code": "471305904",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Jeffersonville, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.