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SAMUEL THOMAS BOSTON M.D.
NPI 1891130241
Pediatrics - Pediatric Gastroenterology in Fort Wayne, IN

Active since April 29, 2013PECOS Enrolled
11123 PARKVIEW PLAZA DR STE 200, FORT WAYNE, IN 46845(260) 425-6100(260) 425-6105 Get Directions Write a Review

NPPES record last updated: March 23, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 23, 2023, Jan 13, 2023, Jul 24, 2019 (3 updates tracked since 2019).

About Samuel Thomas Boston M.d. NPPES

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

SAMUEL THOMAS BOSTON M.D. (NPI 1891130241) is an individual pediatric gastroenterology provider in Fort Wayne, Indiana, licensed in Indiana (01088906A) and active in the NPI registry since April 2013. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1891130241
Entity TypeIndividualMale
Primary Taxonomy2080P0206X
Provider Legal NameSAMUEL THOMAS BOSTONCredential: M.D.
Location Address11123 PARKVIEW PLAZA DR STE 200Fort Wayne, IN 46845-1707
Mailing Address11109 Parkview Plaza Dr # 117Fort Wayne, IN 46845-1701
Phone(260) 425-6100
Fax(260) 425-6105
Sole ProprietorNo
Enumeration DateApril 29, 2013
Last NPPES UpdateMarch 23, 20233 updates tracked since enumeration
NPPES CertifiedMarch 23, 2023
✔ NPI 1891130241 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric GastroenterologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0206X
Licenses✔ Licensed in IN · 01088906A✔ Licensed in OK · 29983✔ Licensed in AR · E-12203
Definition
A pediatrician who specializes in the diagnosis and treatment of diseases of the digestive systems of infants, children and adolescents. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using lighted scopes to see internal organs.
11123 PARKVIEW PLAZA DR STE 200, Fort Wayne, IN 46845
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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)

Samuel Thomas Boston M.d. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 46845 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$122.49 typical visit price
range $53.07 – $161.76
Typical copayment $30.62 (range $13.26 – $40.44)
Most-billed visit code 99204
Established Patient
$94.22 typical visit price
range $16.93 – $132.22
Typical copayment $23.55 (range $4.23 – $33.05)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 8

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

VIMAL JAYSWAL MD
Pediatrics (Pediatric Cardiology)
11123 PARKVIEW PLAZA DR STE 200
FORT WAYNE, IN 46845
Allen County (260) 425-6100
ALDA E. TAUBE
Nurse Practitioner
11123 PARKVIEW PLAZA DR STE 200
FORT WAYNE, IN 46845
Allen County (260) 425-6100
DR. WILLIAM A LOE JR. M.D.
Surgery (Pediatric Surgery)
11123 PARKVIEW PLAZA DR STE 200
FORT WAYNE, IN 46845
Allen County (260) 425-6100
PAUL T. STOCKMANN M.D.
Surgery (Pediatric Surgery)
11123 PARKVIEW PLAZA DR STE 200
FORT WAYNE, IN 46845
Allen County (260) 425-6100
DENISE A GILHAM NP.
Nurse Practitioner
11123 PARKVIEW PLAZA DR STE 200
FORT WAYNE, IN 46845
Allen County (260) 425-6100
DR. EDGARDO D RIVERA-RIVERA M.D.
Pediatrics (Pediatric Gastroenterology)
11123 PARKVIEW PLAZA DR STE 200
FORT WAYNE, IN 46845
Allen County (260) 425-6100
ELAINE BUCHMEIER RD, LD
Dietitian, Registered
11123 PARKVIEW PLAZA DR STE 200
FORT WAYNE, IN 46845
Allen County (260) 425-6100
ROBYN D SCHMUCKER M.D.
Pediatrics (Pediatric Infectious Diseases)
11123 PARKVIEW PLAZA DR STE 200
FORT WAYNE, IN 46845
Allen County (260) 425-6100

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 Samuel Boston's NPI number?

The NPI number for Samuel Boston is 1891130241. It was assigned to this individual provider in the NPPES registry on April 29, 2013.

Where is Samuel Boston located?

Samuel Boston practices at 11123 Parkview Plaza Dr Ste 200, Fort Wayne, IN 46845. The listed phone number is (260) 425-6100.

What is Samuel Boston's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Gastroenterology, with taxonomy code 2080P0206X.

Is Samuel Boston enrolled in Medicare?

Yes. Samuel Boston is registered in the Medicare PECOS enrollment system.

What insurance does Samuel Boston accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Anthem Blue Cross and Blue Shield and CareSource list Samuel Boston as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Samuel Boston was last updated on March 23, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.