NPIMap

Individual provider Active NPI

Ryan T Boone, M.D.

  • Otolaryngology Physician
  • Baton Rouge, LA
National Provider Identifier
1902891476
Registry record updated Mar 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
15385R Issued in LA
Practice address
5258 Dijon Dr
Baton Rouge, LA 70808-4311
Phone
(225) 769-1090
Fax
(225) 769-4812
NPI assigned
Sep 12, 2005
Last updated
Mar 5, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X 15385R LA Primary

Addresses

Primary practice location

5258 Dijon Dr
Baton Rouge, LA 70808-4311

Mailing address

604 N Acadia Rd Ste 101
Thibodaux, LA 70301-4897
Phone (985) 446-5079

Other practice location 1

8200 Constantin Blvd Fl 3
Baton Rouge, LA 70809-3481
Phone (225) 765-6834

Other identifiers 2

IdentifierTypeStateIssuer
1194433MedicaidLA
MD.15385ROtherLASTATE LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040708000243 LA Practitioner - Otolaryngology 9436137411 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Louisiana State University School of Medicine in New Orleans, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Louisiana Ear, Nose, and Throat Specialists, Inc.Group PAC ID 0042313504, 65 clinicians

Practice addresses (Care Compare)

5326 Oak St
Saint Francisville, LA 70775-4510
Phone (225) 769-1090

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60.95 of 100Reported as group
Quality
35.55
Promoting interoperability
88
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
15385RLAMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Ear, Nose, & Throat Specialists, Inc. Otolaryngology CurrentSince Apr 1, 2024 Accepting new patients
Louisiana Ear, Nose, Throat & Sinus, LLC Otolaryngology CurrentSince Oct 1, 2019 Accepting new patients
Fyzical of Baton Rouge, LLC Past Accepting new patients

Locations

5258 Dijon Dr
Baton Rouge, LA 70808
Phone (225) 408-6900

8080 Bluebonnet Blvd
Ste 2222
Baton Rouge, LA 70810
Phone (225) 408-6900

5326 Oak St
St Francisvle, LA 70775
Phone (225) 635-5848

604 N Acadia Rd
Ste 101
Thibodaux, LA 70301
Phone (985) 446-5079

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1126483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709596800000",
    "number": "1902891476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 N ACADIA RD STE 101",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014897",
            "telephone_number": "985-446-5079",
            "fax_number": "985-447-2497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5258 DIJON DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084311",
            "telephone_number": "225-769-1090",
            "fax_number": "225-769-4812"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8200 Constantin Blvd Fl 3",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708093481",
            "country_code": "US",
            "telephone_number": "225-765-6834",
            "fax_number": "225-765-5543",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOONE",
        "first_name": "RYAN",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-12",
        "last_updated": "2024-03-05",
        "certification_date": "2024-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "15385R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1194433",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD.15385R",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.