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DR. GARY DEAVER BOSTON M.D. NPI 1063414241


NPI Information

NPI: 1063414241
Provider Name: DR. GARY DEAVER BOSTON, M.D.
Classification: Orthopaedic Surgery - 207X00000X
Entity Type: Individual
Address:
4212 N 16TH ST
PHOENIX, AZ
ZIP 85016
Phone: (602) 263-1200
Get Directions

DR. Gary Deaver Boston, M.D. is an orthopaedic surgery in Phoenix, AZ. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. DR. Gary Deaver Boston, M.D. NPI is 1063414241. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

4212 N 16TH ST
PHOENIX, AZ
ZIP 85016-319
Phone: (602) 263-1200
Fax: (602) 200-5383

The enumeration date for this NPI number is 6/1/2005 and was last updated on 10/21/2015.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207X00000XOrthopaedic Surgery0418345KANSASYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1B91040MEDICARE UPIN
21394467MEDICARE ID-TYPE UNSPECIFIEDKANSAS
3J354467MEDICARE ID-TYPE UNSPECIFIEDMISSOURI
4104517MEDICARE ID-TYPE UNSPECIFIEDKANSAS
5100083430AMEDICAIDKANSAS
6201305919MEDICAIDMISSOURI

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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