ETHAN GEORGE BOYKO
NPI 1508791120
Anesthesiologist Assistant in Rock Hill, SC

Q: What is Ethan Boyko's NPI number?

The NPI number for Ethan Boyko is 1508791120. It was assigned to this individual provider in the NPPES registry on June 15, 2026.

Q: What is Ethan Boyko's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Ethan Boyko was last updated on July 16, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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 15, 2026

222 HERLONG AVE S, ROCK HILL, SC 29732(803) 329-6711(803) 329-5120 Get Directions Write a Review

NPPES record last updated: July 16, 2026. Verified against the NPPES registry weekly; last sync: September 27, 2026.

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About Ethan George Boyko NPPES

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

ETHAN GEORGE BOYKO (NPI 1508791120) is an individual anesthesiologist assistant in Rock Hill, South Carolina, licensed in South Carolina (173) and active in the NPI registry since June 2026. He maintains a secondary practice location in Fort Mill and is a graduate of Other (2026).

NPPES Registry Identity

NPI1508791120

Entity TypeIndividualMale

Primary Taxonomy367H00000X

Provider Legal NameETHAN GEORGE BOYKO

Location Address222 HERLONG AVE SRock Hill, SC 29732-1158

Mailing Address222 Herlong Ave SRock Hill, SC 29732-1158 · (803) 329-6711 · Fax (803) 329-5120

Phone(803) 329-6711

Fax(803) 329-5120

Sole ProprietorNo

Medical School CMSOtherGraduated 2026

Enumeration DateJune 15, 2026

Last NPPES UpdateJuly 16, 2026

NPPES CertifiedJuly 16, 2026

✔ NPI 1508791120 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

License✔ Licensed in SC · 173

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

222 HERLONG AVE S, Rock Hill, SC 29732

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Secondary Practice Location 1

Location 11000 Wellness WayFort Mill, SC 29715-7315 · Phone (803) 802-3662

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ethan George Boyko is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4789140278

PECOS Enrollment IDI20260724003400

Other Providers at the Same Location NPPES 20

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

ERIKA CHRISTINE DRUTIS PHARMD

Pharmacist