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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

JORDAN T BOIVIN MD
NPI 1346863750
Orthopaedic Surgery - Sports Medicine in Kalamazoo, MI

Active since May 20, 2020PECOS Enrolled
2490 S 11TH ST STE 201, KALAMAZOO, MI 49009(269) 343-1535(269) 343-0418 Get Directions Write a Review

NPPES record last updated: September 3, 2026. Verified against the NPPES registry weekly; last sync: September 13, 2026.

Record update history: Sep 3, 2026, Jun 17, 2020, May 20, 2020 (3 updates tracked since 2020).

About Jordan T Boivin Md NPPES

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

JORDAN T BOIVIN MD (NPI 1346863750) is an individual sports medicine provider in Kalamazoo, Michigan, licensed in Michigan (4301517677) and active in the NPI registry since May 2020. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Wright State University Boonshoft School Of Medicine (2020).

NPPES Registry Identity

NPI1346863750
Entity TypeIndividualMale
Primary Taxonomy207XX0005X
Provider Legal NameJORDAN T BOIVINCredential: MD
Location Address2490 S 11TH ST STE 201Kalamazoo, MI 49009-2175
Mailing Address3245 Health Dr Ste 100Granger, IN 46530-1380 · (269) 552-2823 · Fax (269) 552-2964
Phone(269) 343-1535
Fax(269) 343-0418
Sole ProprietorNo
Medical School CMSWright State University Boonshoft School Of MedicineGraduated 2020
Enumeration DateMay 20, 2020
Last NPPES UpdateSeptember 3, 20263 updates tracked since enumeration
NPPES CertifiedSeptember 3, 2026
✔ NPI 1346863750 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyOrthopaedic Surgery · Sports MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207XX0005X
License✔ Licensed in MI · 4301517677
Definition
An orthopaedic surgeon trained in sports medicine provides appropriate care for all structures of the musculoskeletal system directly affected by participation in sporting activity. This specialist is proficient in areas including conditioning, training and fitness, athletic performance and the impact of dietary supplements, pharmaceuticals, and nutrition on performance and health, coordination of care within the team setting utilizing other health care professionals, field evaluation and management, soft tissue biomechanics and injury healing and repair. Knowledge and understanding of the principles and techniques of rehabilitation, athletic equipment and orthotic devices enables the specialist to prevent and manage athletic injuries.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X · License 4351046936 (MI)
2490 S 11TH ST STE 201, Kalamazoo, MI 49009
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Secondary Practice Locations 2

Location 11000 Oakland DrKalamazoo, MI 49008-1282 · Phone (269) 337-4600
Location 21021 Hill St Ste 300Three Rivers, MI 49093-2744 · Phone (269) 858-3024 · Fax (269) 273-9040

Other Identifiers 1

Medicaid1346863750MI

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jordan T Boivin Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9032531983
PECOS Enrollment IDI20260812002596
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 4

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

NATHAN C NURRE
Physician Assistant (Medical)
2490 S 11TH ST STE 201
KALAMAZOO, MI 49009
Kalamazoo County (269) 343-1535
DR. BROCK ANDREW HARDIN M.D.
Family Medicine (Sports Medicine)
2490 S 11TH ST STE 201
KALAMAZOO, MI 49009
Kalamazoo County (269) 343-1535
ANA ARNOLD PA-C
Physician Assistant
2490 S 11TH ST STE 201
KALAMAZOO, MI 49009
Kalamazoo County (269) 343-1535
DR. WILLIAM ARTHUR ZUKE MD
Orthopaedic Surgery (Adult Reconstructive Orthopaedic Surgery)
2490 S 11TH ST STE 201
KALAMAZOO, MI 49009
Kalamazoo County (269) 343-1535

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jordan Boivin's NPI number?

The NPI number for Jordan Boivin is 1346863750. It was assigned to this individual provider in the NPPES registry on May 20, 2020.

Where is Jordan Boivin located?

Jordan Boivin practices at 2490 S 11th St Ste 201, Kalamazoo, MI 49009. The listed phone number is (269) 343-1535.

What is Jordan Boivin's specialty?

The primary specialty registered for this NPI is Orthopaedic Surgery, specializing in Sports Medicine, with taxonomy code 207XX0005X.

Is Jordan Boivin enrolled in Medicare?

Yes. Jordan Boivin is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jordan Boivin was last updated on September 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 days 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.