MEDICARE: JOSEPH A BOIVIN OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	ODTG00482	RI

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
12	410040026	OTHER	RI	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	400630	OTHER	RI	BLUE CHIP
2	5761621	OTHER	RI	AETNA
3	26587	OTHER	RI	RI BLUE SHIELD
4	0859	OTHER	RI	NHP RI GROUP #
5	759127	OTHER	RI	TUFTS
6	2814	OTHER	RI	NEIGHBORHOOD RI
7	6915366	OTHER	RI	CIGNA
8	AA6678	OTHER	RI	HARVARD
9	2200041	OTHER	RI	UNITED
10	603940	OTHER	RI	TUFTS - GROUP #
11	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174509921
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH A BOIVIN OD

Provider Business Mailing Address
First Line	:	1820 MAIN RD
Second Line	:
City	:	TIVERTON
State	:	RI
Zip	:	02878-4625
Country	:	US
Telephone Number	:	401-624-6672
Fax Number	:	401-624-4769

Provider Business Practice Location Address
First Line	:	1820 MAIN RD
Second Line	:
City	:	TIVERTON
State	:	RI
Zip	:	02878-4625
Country	:	US
Telephone Number	:	401-624-6672
Fax Number	:	401-624-4769

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/22/2005
Last Update Date	:	02/05/2026

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Directions to “ JOSEPH A BOIVIN OD” Practice Location

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