DR. JACKSON WYATT BOICE (MD) – Diagnostic Radiology Physician, NPI 1104319664
Diagnostic Radiology Physician
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
249 DIAGNOSTIC RADIOLOGY in NE
Provider Addresses for DR. JACKSON WYATT BOICE (MD)
6350 CEDAR PLZ APT 210
OMAHA, NE 681062269
Phone: (417) 682-4643
Type: Mailing
S 42ND ST AND EMILE ST
OMAHA, NE 681988500
Phone: (417) 682-4643
Type: Location
PO BOX 60352
SAINT LOUIS, MO 631600352
Phone: (314) 362-7200
Fax: (314) 747-4189
Type: Mailing
510 S KINGSHIGHWAY BLVD
DEPT RADIOLOGY
SAINT LOUIS, MO 631101016
Phone: (314) 362-7200
Fax: (314) 747-4189
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2024-07-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20230618000141 | I | Diagnostic Radiology | MO | TBD |
| I20240725000271 | I | Diagnostic Radiology | KS | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 73030 | X-ray of shoulder, minimum of 2 views | 130 | 114 | $0 |
| 73630 | X-ray of foot, minimum of 3 views | 109 | 95 | $0 |
| 73562 | X-ray of knee, 3 views | 84 | 73 | $0 |
| 73502 | X-ray of hip, 2-3 views | 75 | 73 | $0 |
| 72084 | X-ray of entire middle and lower spine, minimum of 6 views | 65 | 65 | $0 |
Insurance plans in this area (ZIP 68106)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Diagnostic Radiology, Interventional Radiology | KS | |
| Diagnostic Radiology | CA | |
| Diagnostic Radiology | KS | |
| Diagnostic Radiology | KS | |
| Diagnostic Radiology, Nuclear Medicine | KS | |
| Diagnostic Radiology | WI | |
| Diagnostic Radiology | OK | |
| Diagnostic Radiology | KS | |
| Physician Assistant | NE | |
| - | KS |
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