IVY BOYDSTUN MD
NPI 1285671628
Pediatrics - Pediatric Nephrology in Hollywood, FL

Q: What is Ivy Boydstun's NPI number?

The NPI number for Ivy Boydstun is 1285671628. It was assigned to this individual provider in the NPPES registry on June 2, 2006.

Q: What is Ivy Boydstun's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Nephrology, with taxonomy code 2080P0210X.

Q: When was this NPI record last updated?

The NPPES record for Ivy Boydstun was last updated on March 17, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since June 02, 2006PECOS Enrolled

1131 N 35TH AVE FL 2, HOLLYWOOD, FL 33021(954) 265-9344(954) 986-5122 Get Directions Write a Review

NPPES record last updated: March 17, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Mar 17, 2021, Jun 26, 2018 (2 updates tracked since 2018).

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About Ivy Boydstun Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

IVY BOYDSTUN MD (NPI 1285671628) is an individual pediatric nephrology provider in Hollywood, Florida, licensed in Florida (ME101007) and active in the NPI registry since June 2006. She is enrolled in Medicare PECOS and maintains a secondary practice location in Boca Raton.

NPPES Registry Identity

NPI1285671628

Entity TypeIndividualFemale

Primary Taxonomy2080P0210X

Provider Legal NameIVY BOYDSTUNCredential: MD

Location Address1131 N 35TH AVE FL 2Hollywood, FL 33021

Mailing Address2900 Corporate Way, Door DMiramar, FL 33025-3925 · (954) 276-5685 · Fax (954) 985-7074

Phone(954) 265-9344

Fax(954) 986-5122

Sole ProprietorNo

Enumeration DateJune 2, 2006

Last NPPES UpdateMarch 17, 20212 updates tracked since enumeration

NPPES CertifiedMarch 17, 2021

✔ NPI 1285671628 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric NephrologyAllopathic & Osteopathic Physicians

Taxonomy Code2080P0210X

License✔ Licensed in FL · ME101007

Definition

A pediatrician who deals with the normal and abnormal development and maturation of the kidney and urinary tract, the mechanisms by which the kidney can be damaged, the evaluation and treatment of renal diseases, fluid and electrolyte abnormalities, hypertension and renal replacement therapy.

1131 N 35TH AVE FL 2, Hollywood, FL 33021

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Secondary Practice Location 1

Location 1900 Glades Rd Ste 501Boca Raton, FL 33431-6421 · Phone (954) 265-9344 · Fax (954) 986-5122

Other Identifiers 1

Medicaid000070000FL

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include AmeriHealth Caritas Next, AvMed, Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ivy Boydstun Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

RAIZA EXANTUS MD

Medical Genetics (Clinical Genetics (M.D.))