DANE BOYACK (DO) – Emergency Medicine Physician, NPI 1649682303

DANE BOYACK (DO) is a healthcare provider. based in Fort worth, Texas. specializing in EMERGENCY MEDICINE. They hold the professional credentials DO. They hold a License No. 05-39854 (KS). The NPI Number for DANE BOYACK (DO) is 1649682303

Main info

Male
Sole Proprietor
12 Years Of Experience
Accepts Medicare Assignment
Name
DANE BOYACK (DO)
NPI
1649682303
Phone
(817) 702-8772
Address
1500 S MAIN ST
Enumeration Date
28 May 2014
Last Update Date
8 February 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
7812801589
Graduation Year
2014 (12 years ago)
PAC ID
2961797907
Group Practice PAC ID
2860458544
Professional Enrollment ID
I20170518000104
Address ID
KS660673537OT1301XSTXX400
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness75
Years active:12State licenses:1Digital endpointsOther names

4,066 EMERGENCY MEDICINE in TX

Provider Addresses for DANE BOYACK (DO)

  • 1500 S MAIN ST

    FORT WORTH, TX 761044917

    Phone: (817) 702-8772

    Type: Mailing

  • 9100 W 74TH ST

    MERRIAM, KS 662044004

    Phone:

    Type: Mailing

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: 2017-05-18

PECOS data refreshed: 2026-06-15

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20170518000104IEmergency MedicineKSTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99285Emergency department visit with high level of medical decision making8484$0
99284Emergency department visit with moderate level of medical decision making5959$0
99283Emergency department visit with low level of medical decision making2828$0
99291Critical care, first 30-74 minutes2424$0
View full utilization report →

Insurance plans in this area (ZIP 76104)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2860458544View full group profile
NameSpecialtyState
Emergency MedicineKS
Emergency MedicineKS
Emergency MedicineKS
Emergency MedicineMI
Emergency MedicineOH
Emergency MedicineKS
Emergency MedicineKS
Emergency MedicineWI
Emergency MedicineNJ
Emergency MedicineKS

Reviews

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Frequently asked questions

How is DANE BOYACK (DO) identified in CMS data?
CMS-hosted NPPES data lists DANE BOYACK (DO) with NPI 1649682303.
Is DANE BOYACK (DO) listed as active for patients and plans?
The listing shows DANE BOYACK (DO) as active in the NPI system.
What is DANE BOYACK (DO) best known for clinically?
Directory data describes DANE BOYACK (DO) with Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What area does DANE BOYACK (DO) serve?
DANE BOYACK (DO)'s listing highlights Fort Worth, Texas; more addresses can appear in NPPES.
Why does DANE BOYACK (DO) have multiple addresses?
4 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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