MR. DERRICK BOYD (NPI# 1962668657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962668657 |
| Entity Type | Individual |
| Full Name | MR. DERRICK BOYD |
| Other Name | MR. DERRICK BOYD |
| Credential | PA |
| Practice Address |
561 Fairthorne Ave. Fairmount Behavioral Health System Philadelphia PA 19128 |
| Mailing Address |
561 Fairthorne Ave Fairmount Behavioral Health System Philadelphia PA 19128 |
| Practice Telephone | 2155823405 |
| Mailing Fax Number | 2675823405 |
| Enumeration Date | 2008-08-01 |
| Last Update Date | 2015-05-01 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | MA003235L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
MA003235L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
MA003235L | PA | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376153874 | Derrick Boyd | Physical Therapy Assistant | 1373 Dadrian Professional Park, Godfrey, IL 62035-1767 | 2020-08-09 |
| 1255696670 | Derrick F Boyd | Case Manager/Care Coordinator | 379 6th Ave W, Bradenton, FL 34205-8820 | 2012-07-11 |
| Street Address |
561 FAIRTHORNE AVE. FAIRMOUNT BEHAVIORAL HEALTH SYSTEM |
| City | PHILADELPHIA |
| State | PA |
| Zip Code | 19128 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851877179 | Andrew Mermelstein | Podiatrist | 5800 Roxborough Avenue, Philadelphia, PA 19128 | 2018-07-19 |
| 1811499361 | Ursula Wacyk | Social Worker | 6122 Ridge Avenue, Philadelphia, PW 19128 | 2018-03-01 |
| 1417478454 | Chelsea Lynn Roberts | Physician Assistant | 707 Autumn River Run, Philadelphia, PA 19128 | 2017-06-29 |
| 1174060503 | Melody Ann Piranian | Nurse Practitioner | Andorra Pediatrics, 8945 Ridge Ave St 5, Phila, PA 19128 | 2017-01-24 |
| 1154874410 | Meghan Smith | Pharmacist | 5927-59 Ridge Ave, Philadelphia, PA 19128 | 2016-08-03 |
| 1356797880 | Jenna Angelo | Registered Nurse | 457 Spring Lane, Philadelphia, PA 19128 | 2016-05-13 |
| 1689049843 | Newcourtland Senior Centers | Clinic/Center | 4200b Mitchell Street, Suie 1000, Philadelphia, PA 19128 | 2015-12-14 |
| 1235519331 | Merin Wexler | Social Worker | 6060 Ridge Avenue, Suite 210, Philadelphia, PA 19128 | 2015-06-03 |
| 1457754335 | Sarah De Simone | Specialist/Technologist | 318 Fountain Street, Philadelphia, PA 19128 | 2014-10-06 |
| 1609280049 | Sylvia Russianoff | Counselor | 128 Rochelle Avenue, Philadelphia, PA 19128 | 2014-06-13 |
| Find all providers in zip 19128 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780283986 | Margaret Ann Malloy | Physician Assistant | 3223 N Broad St Fl 1, Philadelphia, PA 19140-5007 | 2020-10-20 |
| 1174122493 | Juliana Debnam | Physician Assistant | 235 S 15th St Apt 904, Philadelphia, PA 19102-5031 | 2020-10-19 |
| 1457950867 | Kyllington Spotts | Physician Assistant | 1151 N 3rd St Unit 301, Philadelphia, PA 19123-1578 | 2020-10-19 |
| 1598375925 | Meredith Jeanne Behr | Physician Assistant | 5401 N Broad St, Philadelphia, PA 19141 | 2020-07-31 |
| 1457977944 | Jiyean Yoo | Physician Assistant | 2929 Walnut St Apt 4424, Philadelphia, PA 19104-5096 | 2020-06-19 |
| 1356987747 | Jennifer Rose Cueni | Physician Assistant | 2120 Brandywine St, Philadelphia, PA 19130-3107 | 2019-11-21 |
| 1730740408 | Olivia Anne Leventry | Physician Assistant | 109 Fairmount Ave, Philadelphia, PA 19123-3004 | 2019-06-24 |
| 1588136055 | Jefferson University Physcians | Physician Assistant | 1020 Sansom St Fl 10, Philadelphia, PA 19107-5002 | 2018-12-21 |
| 1649751843 | Rachel Wint | Physician Assistant | 231 N Broad St Fl 2, Philadelphia, PA 19107 | 2018-08-24 |
| 1922589365 | Rachel Diane Simonsen | Physician Assistant | 1741 Frankford Ave Ste 100a, Philadelphia, PA 19125-2445 | 2018-08-23 |
| Find all providers in PHILADELPHIA | ||||
| City | PHILADELPHIA |
| Zip Code | 19128 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.