Olivia Gayle Boggan

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

134 Vision Park Blvd Ste 300
Shenandoah, TX 77384-3032

Phone

(281) 296-8500

NPI assigned

Jun 15, 2023

Last updated

Jun 15, 2023By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Physician Assistant

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Privia Medical Group Gulf Coast PLLCGroup PAC ID 4688999022, 511 clinicians

Legacy Healthcare Services IncGroup PAC ID 2163339722, 3,431 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vitalcaring Group Home health agency, Henderson, TX, CCN 458072
• Tops Surgical Specialty Hospital Hospital, Houston, TX, CCN 450774
• Memorial Hermann Hospital System Hospital, Houston, TX, CCN 450184

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: olivia.boggan.1@8042.direct.athenahealth.com

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.

• Privia Medical Group Gulf Coast, PLLC

  • Obstetrics & Gynecology Physician
  • Houston, TX
  • NPI 1578969465
  Medicare reassignment Care Compare group NPD
• Legacy Healthcare Services Inc.

  • Physical Therapist
  • Cedar Park, TX
  • NPI 1871132357
  Care Compare group

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

• Memorial Hermann Health System

  dba MHHS NW Radiation Therapy

  • Radiology Clinic/Center
  • Houston, TX
  • NPI 1013948553

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  dba MHHS Woodlands Outpatient Imaging System

  • Radiology Clinic/Center
  • The Woodlands, TX
  • NPI 1275564858

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  dba Memorial Hermann Outpatient Imaging-Southwest

  • Radiology Clinic/Center
  • Houston, TX
  • NPI 1407959448

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  dba MHHS Friendswood Imaging

  • Radiology Clinic/Center
  • Friendswood, TX
  • NPI 1508896267

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  dba MHHS Pearland Outpatient Imaging Center

  • Radiology Clinic/Center
  • Pearland, TX
  • NPI 1669402335

  Hospital

  Care Compare affiliation
• Memorial Hermann Health System

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1730132234
  Care Compare affiliation
• Northeast Texas Home Health Agency LTD

  dba VitalCaring Group

  • Home Health Agency
  • Henderson, TX
  • NPI 1871632513
  Care Compare affiliation
• Tops Specialty Hospital, LTD.

  dba TOPS Surgical Specialty Hospital

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1144203662
  Care Compare affiliation

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1952086274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19107 W SAWTOOTH CANYON DR",
            "city": "TOMBALL",
            "state": "TX",
            "postal_code": "773777898",
            "telephone_number": "214-549-7179"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "134 VISION PARK BLVD STE 300",
            "city": "SHENANDOAH",
            "state": "TX",
            "postal_code": "773843032",
            "telephone_number": "281-296-8500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOGGAN",
        "first_name": "OLIVIA",
        "middle_name": "GAYLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Marie Blanchard, PT, DPT
• Eric R Blanson, DPM
• Rhane Blosser
• Kathe Boarman
• Stephanie Bodet, AU.D.
• Laura Belorgey Bonds, MD
• Katherine Borths, PA-C
• Veronika Boulantsova
• Aranyanee Bowers, D.O.
• Alfred A Boyd, MD

• Physician Assistant in Shenandoah, TX
• Providers in Shenandoah, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.