Dr Michelle Allison Boston, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Tampa, Florida. Her current practice location is
13000 Bruce B Downs Blvd, Tampa, Florida. You can reach out to her office (for appointments etc.) via phone at
(813) 972-2000.
Dr Michelle Allison Boston is licensed to practice in Florida (license number PY12060) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1457109902.
Healthcare Provider's Profile
Full Name | Dr Michelle Allison Boston |
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Gender | Female |
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Speciality | Clinical Neuropsychologist |
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Location | 13000 Bruce B Downs Blvd, Tampa, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1457109902
- Provider Enumeration Date: 05/09/2024
- Last Update Date: 10/17/2024
Medicare PECOS Information:
- PECOS PAC ID: 4688114044
- Enrollment ID: I20240911004676
Medical Identifiers
Medical identifiers for Dr Michelle Allison Boston such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1457109902 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103TC0700X | Psychologist - Clinical | PY12060 (Florida) | Secondary |
103G00000X | Clinical Neuropsychologist | PY12060 (Florida) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Michelle Allison Boston allows following entities to bill medicare on her behalf.
Entity Name | Baycare Medical Group, Inc. |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1043269871 PECOS PAC ID: 6406753623 Enrollment ID: O20031216000718 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Michelle Allison Boston is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Michelle Allison Boston, PHD 2995 Drew St Fl 2, Clearwater, FL 33759-3012 Ph: (727) 315-7496 | Dr Michelle Allison Boston, PHD 13000 Bruce B Downs Blvd, Tampa, FL 33612-4745 Ph: (813) 972-2000 |
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