MEDICARE: JAMES E BOATMAN M.D.

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	207RI0011X	Interventional Cardiology Physician	6371392	ID
2	207RC0000X	Cardiovascular Disease Physician	01073511A	IN
3	207RC0000X	Cardiovascular Disease Physician	036101606	IL
4	207RI0011X	Interventional Cardiology Physician	136195	MT
5	207RI0011X	Interventional Cardiology Physician	2612-320	WI
6	207RI0011X	Interventional Cardiology Physician	036101606	IL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000000857391	OTHER	IN	ANTHEM PROVIDER NUMBER
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1285615724
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES E BOATMAN M.D.

Provider Business Mailing Address
First Line	:	3100 N KENMORE AVE APT E
Second Line	:
City	:	CHICAGO
State	:	IL
Zip	:	60657-3472
Country	:	US
Telephone Number	:	773-343-6322
Fax Number	:

Provider Business Practice Location Address
First Line	:	1086 FRANKLIN ST
Second Line	:
City	:	JOHNSTOWN
State	:	PA
Zip	:	15905-4305
Country	:	US
Telephone Number	:	814-534-9005
Fax Number	:

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

Provider Enumeration Date	:	11/10/2005
Last Update Date	:	02/10/2026

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Directions to “ JAMES E BOATMAN M.D.” Practice Location

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