Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. Ethan Westley Boardman, PA-C

Individual provider Physician Assistant · NPI 1184378549

Mr. Ethan Westley Boardman, PA-C is a Physician Assistant in Columbus, Ohio. Qualified in 2021, 5 years ago. Practices with Central Ohio Primary Care Physicians, Inc, a 487-clinician group and accepts Medicare assignment. Licensed in Ohio.

Years since qualifying
5
Licensed in
OH
In the registry since
2022
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

4885 Olentangy River Rd Ste 1-20
Columbus, OH 43214-1953
Phone: (614) 268-6555
Fax: (614) 457-5713
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 50.007417RX (OH)

Record details

NPI number1184378549
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 4, 2022
Last updated in NPPESAugust 14, 2024
Certification dateAugust 14, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Central Ohio Primary Care Physicians, Inc. — 487 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations6 on file with Medicare

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