Kirsten Bo, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9104713 Issued in FL

Practice address

21110 Biscayne Blvd
Suite 308
Aventura, FL 33180-1227

Phone

(305) 932-1007

NPI assigned

May 12, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: kbo71403@epicdirect.hf.org

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

• Brevard Physician Associates, PLLC

  • Anesthesiology Physician
  • Melbourne, FL
  • NPI 1598008955
  Medicare reassignment
• Brevard Emergency Services

  • Internal Medicine Physician
  • Melbourne, FL
  • NPI 1104870393
  NPD (past)

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

{
    "created_epoch": "1242086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1242086400000",
    "number": "1164656609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21110 BISCAYNE BLVD",
            "address_2": "SUITE 308",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801227"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21110 BISCAYNE BLVD",
            "address_2": "SUITE 308",
            "city": "AVENTURA",
            "state": "FL",
            "postal_code": "331801227",
            "telephone_number": "305-932-1007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BO",
        "first_name": "KIRSTEN",
        "name_prefix": "Miss",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-05-12",
        "last_updated": "2009-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9104713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marina C Blachman
• Jackqueline Blezio, M.S., C.C.C.
• Paola Blitzer, MHC
• Norman Arthur Bloom, MD
• Blue Butterfly Psychiatric Services. LLC
• Bojana Bjekic-Bhardwaj MD PA
• Courtney Nicole Bolick, ARNP
• Bond Aesthetic, P.a.
• Jennifer Bonifacio
• Ashley Borbon

• Physician Assistant in Aventura, FL
• Providers in Aventura, FL by specialty
• Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.