JUSTIN DAVID BOER M.D.
Complete NPI Record 1609326800
Hospitalist in York, PA
Active since October 11, 2016PECOS Enrolled
Complete NPI Dataset
This page contains the complete raw NPPES record for Justin David Boer, M.D. (NPI 1609326800), an individual hospitalist provider in York, PA. All 37 fields on file are listed with their current values and official NPPES definitions, exactly as recorded in the National Plan and Provider Enumeration System. Only fields that contain data are included, so the number of fields shown varies from one NPI record to another.
Use the tools below to filter fields by category, search within the record, or jump straight to a specific field. You can download the full record as a CSV, JSON, or text file, or filter first and export only the fields you need. The Print Clean Summary button produces a printer-friendly copy of the record.
Registry File Document Utilities
- NPI: 1609326800 Field 1/37
- The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
- Entity Type Code: 1 Field 2/37
- Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
- Provider Last Name Legal Name: BOER Field 3/37
- The last name of the provider. If the provider is an individual, this is the legal name.
- Provider First Name: JUSTIN Field 4/37
- The first name of the provider, if the provider is an individual.
- Provider Middle Name: DAVID Field 5/37
- The middle name of the provider, if the provider is an individual.
- Provider Credential Text: M.D. Field 6/37
- The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
- Provider First Line Business Mailing Address: 601 MEMORY LN Field 7/37
- The first line mailing address of the provider being identified. This data element may contain the same information as "Provider first line location address".
- Provider Business Mailing Address City Name: YORK Field 8/37
- The city name in the mailing address of the provider being identified.
- Provider Business Mailing Address State Name: PA Field 9/37
- The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address State name".
- Provider Business Mailing Address Postal Code: 174022231 Field 10/37
- The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as "Provider location address postal code".
- Provider Business Mailing Address Country Code If outside U S : US Field 11/37
- The country code in the mailing address of the provider being identified. This data element may contain the same information as "Provider location address country code".
- Provider Business Mailing Address Telephone Number: 7178511405 Field 12/37
- The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as "Provider location address telephone number".
- Provider Business Mailing Address Fax Number: 7178516969 Field 13/37
- The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as "Provider location address fax number".
- Provider First Line Business Practice Location Address: 1001 S GEORGE ST Field 14/37
- The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
- Provider Business Practice Location Address City Name: YORK Field 15/37
- The city name in the location address of the provider being identified.
- Provider Business Practice Location Address State Name: PA Field 16/37
- The State code in the location of the provider being identified.
- Provider Business Practice Location Address Postal Code: 174033676 Field 17/37
- The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
- Provider Business Practice Location Address Country Code If outside U S : US Field 18/37
- The country code in the location address of the provider being identified.
- Provider Business Practice Location Address Telephone Number: 7178513884 Field 19/37
- The telephone number associated with the location address of the provider being identified.
- Provider Business Practice Location Address Fax Number: 7178513382 Field 20/37
- The fax number associated with the location address of the provider being identified.
- Provider Gender Code: M Field 23/37
- The code designating the provider's gender if the provider is a person.
- Healthcare Provider Taxonomy Code 1: 208M00000X Field 24/37
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 1: MD464968 Field 25/37
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 1: PA Field 26/37
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 1: Y Field 27/37
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Healthcare Provider Taxonomy Code 2: 208000000X Field 28/37
- This field represents the provider's taxonomy code, which classifies their type, classification, and area of specialization. This code comes from the Healthcare Provider Taxonomy Code Set maintained by the National Uniform Claim Committee (NUCC). The NPS will associate these data with the license data for providers with Entity type code = 1.
- Provider License Number 2: MD464968 Field 29/37
- The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with "provider taxonomy code".
- Provider License Number State Code 2: PA Field 30/37
- The two-letter state code representing the U.S. state or territory that issued the provider's license. This field is linked to the Provider License Number field and identifies the jurisdiction where that license is valid. A provider may have multiple state codes if they hold licenses in more than one state.
- Healthcare Provider Primary Taxonomy Switch 2: N Field 31/37
- This field shows whether the related taxonomy code is the provider's primary specialty. It is a single-character value: "Y" indicates the taxonomy is the primary one, while "N" indicates it is not. Each provider record can have only one taxonomy code marked as primary.
- Other Provider Identifier 1: MD464968 Field 32/37
- An additional identifier number for the provider, either current or previously used. This may include IDs issued by health plans, state agencies, or other organizations. The value is collected from the NPI application or update form.
- Other Provider Identifier Type Code 1: 01 Field 33/37
- A code that specifies the type of additional identifier associated with the provider, either current or past. Examples include UPIN (Universal Provider Identification Number), NSC (National Supplier Clearinghouse), OSCAR (CMS Certification Number), DEA (Drug Enforcement Administration number), state Medicaid ID, or a plan-specific PIN. The value is collected from the NPI application or update form.
- Other Provider Identifier State 1: PA Field 34/37
- The two-letter state code representing the U.S. state or territory that issued the additional provider identifier. This links the Other Provider Identifier to the state where it is valid or was assigned.
- Other Provider Identifier Issuer 1: PA MEDICAL LICENSE Field 35/37
- The name of the organization, agency, or health plan that assigned the additional provider identifier. This identifies who issued the number linked to Other Provider Identifier 1 (for example, a state Medicaid agency, Medicare, or a private insurance company).
- Is Sole Proprietor: N Field 36/37
- Indicates whether the provider is registered as a sole proprietor. This is a single-character code: "Y" means the provider operates as a sole proprietor, and "N" means they do not.
Secondary Practice Locations 19
The first line of the secondary practice location address of the provider being identified. For providers with more than one physical location, this is a secondary practice location address. This address cannot include a Post Office box.
4020 Carlisle Rd
Location 1/19Dover, PA 17315-3508 · Phone (717) 812-4240 · Fax (717) 851-6460
717 Town Center Dr
Location 2/19York, PA 17408 · Phone (717) 356-4240
2339 S George St
Location 3/19York, PA 17403-5009 · Phone (717) 812-3040 · Fax (717) 741-3028
2050 S Queen St
Location 4/19York, PA 17403-4829 · Phone (717) 812-4240 · Fax (717) 848-5520
100 Eisenhower Dr
Location 5/19Hanover, PA 17331-5241 · Phone (717) 646-4201
4050 N George Street Ext
Location 6/19Manchester, PA 17345-9347 · Phone (717) 356-4370
101 W Airport Rd
Location 7/19Lititz, PA 17543-9274 · Phone (717) 466-2445
446 N Reading Rd
Location 8/19Ephrata, PA 17522-9802 · Phone (717) 738-5275
96 Sofia Dr
Location 9/19Shrewsbury, PA 17361-5201 · Phone (717) 812-2400
2149 S Queen St
Location 10/19York, PA 17403-4845 · Phone (717) 356-4460
9 Nathan Ln
Location 11/19Annville, PA 17003-6500 · Phone (717) 639-3350
455 S Washington St Ste 12
Location 12/19Gettysburg, PA 17325-2516 · Phone (717) 339-2875
2675 Joppa Rd
Location 13/19York, PA 17403-5160 · Phone (717) 741-9063 · Fax (717) 718-9779
147 Gettys St
Location 14/19Gettysburg, PA 17325-2534 · Phone (717) 851-3884
252 S 4th St
Location 15/19Lebanon, PA 17042-6111 · Phone (717) 851-2613
15 Constitution Ave
Location 16/19Shrewsbury, PA 17361-1709 · Phone (717) 235-6848 · Fax (717) 759-6770
3065 Windsor Rd
Location 17/19Red Lion, PA 17356-8533 · Phone (717) 812-3040 · Fax (717) 741-3028
2003 E Market St
Location 18/19York, PA 17402-2841 · Phone (717) 851-7665 · Fax (717) 755-7569
618 Cornwall Rd
Location 19/19Lebanon, PA 17042-7089 · Phone (717) 279-6700 · Fax (717) 279-6759
Other Provider Identifiers 1
Legacy and payer-issued identifiers reported to the NPPES registry for this provider.
MD464968 Other
Identifier 1/1State: PA · Issuer: Pa Medical License
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
Other: An additional provider identifier that does not correspond to any of the other defined identifier type categories.
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