Individual provider Active NPI

Erin Boensch, PA-C

  • Physician Assistant
  • Clio, MI
National Provider Identifier
1043819014
Registry record updated Mar 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
5601012705 Issued in MI
Practice address
4272 W Vienna Rd
Clio, MI 48420-9501
Phone
(810) 919-9415
NPI assigned
Oct 21, 2020
Last updated
Mar 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 5601012705 MI Primary

Addresses

Primary practice location

4272 W Vienna Rd
Clio, MI 48420-9501

Mailing address

9577 W Saginaw Rd
Reese, MI 48757-9464
Phone (989) 798-5213

Other practice location 1

1447 N Harrison St
Saginaw, MI 48602-4727
Phone (989) 583-5483

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240918000937 MI Practitioner - Physician Assistant 3971044983 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clio Urgent Care PLLCGroup PAC ID 2062738446, 10 clinicians
Covenant Medical Center, Inc.Group PAC ID 2769387778, 488 clinicians

Practice addresses (Care Compare)

4272 W Vienna Rd
Clio, MI 48420-9501
Phone (810) 919-9415

5570 State St
Saginaw, MI 48603-3583
Phone (989) 583-0100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5601012705MIMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Covenant Medical Center, Inc CurrentSince May 1, 2026 Accepting new patients
Covenant Medical Center, Inc. CurrentSince May 1, 2026 Accepting new patients

Locations

16440 Gratiot Rd
Hemlock, MI 48626
Phone (989) 583-0660

1447 N Harrison St
Saginaw, MI 48602
Phone (989) 583-4220

5570 State St
Saginaw, MI 48603
Phone (989) 583-0100

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1603238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773792000000",
    "number": "1043819014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9577 W SAGINAW RD",
            "city": "REESE",
            "state": "MI",
            "postal_code": "487579464",
            "telephone_number": "989-798-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4272 W VIENNA RD",
            "city": "CLIO",
            "state": "MI",
            "postal_code": "484209501",
            "telephone_number": "810-919-9415"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1447 N Harrison St",
            "address_purpose": "LOCATION",
            "city": "Saginaw",
            "state": "MI",
            "postal_code": "486024727",
            "country_code": "US",
            "telephone_number": "989-583-5483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOENSCH",
        "first_name": "ERIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-21",
        "last_updated": "2026-03-18",
        "certification_date": "2026-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MI",
            "license": "5601012705",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clio, MI

Sources for this page

Verify at the official NPI Registry.