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SAMUEL THOMAS BOSTON M.D. NPI 1891130241


NPI Information

NPI: 1891130241
Provider Name: SAMUEL THOMAS BOSTON, M.D.
Classification: Pediatrics - 2080P0206X
Entity Type: Individual

Specialization: Pediatric Gastroenterology

PECOS Registration: Yes

Address:
11123 PARKVIEW PLAZA DR STE 200
FORT WAYNE, IN
ZIP 46845
Phone: (260) 425-6100
Get Directions

Samuel Thomas Boston, M.D. is a pediatric gastroenterology pediatrics in Fort Wayne, IN. The provider is a pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs. Samuel Thomas Boston, M.D. NPI is 1891130241. 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:

11123 PARKVIEW PLAZA DR STE 200
FORT WAYNE, IN
ZIP 46845-707
Phone: (260) 425-6100
Fax: (260) 425-6105

The NPI 1891130241 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 4/29/2013 and was last updated on 3/23/2023.


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
12080P0206XPediatricsPediatric Gastroenterology29983OKLAHOMANo
22080P0206XPediatricsPediatric GastroenterologyE-12203ARKANSASNo
32080P0206XPediatricsPediatric Gastroenterology01088906AINDIANAYes

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

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.