Individual provider Active NPI

Kimberley Jean Boosales, C-AA

  • Anesthesiologist Assistant
  • Safety Harbor, FL
National Provider Identifier
1205257136
Registry record updated Feb 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA211 Issued in FL
Practice address
3231 McMullen Booth Rd
Safety Harbor, FL 34695
Phone
(727) 725-6111
NPI assigned
Dec 19, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X AA211 FL Primary

Addresses

Primary practice location

3231 McMullen Booth Rd
Safety Harbor, FL 34695

Mailing address

PO Box 100254
Gainesville, FL 32610-0254
Phone (352) 273-8610

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-3003
Phone (352) 273-8610

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140417001160 FL Practitioner - Anesthesiology Assistant 7315179793 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Medical Group, Inc.Group PAC ID 6406753623, 1,539 clinicians

Practice addresses (Care Compare)

2461 Enterprise Rd
Suite C
Clearwater, FL 33763-1726
Phone (727) 725-5060

3001 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307
Phone (813) 321-6589

3003 W Dr Martin Luther King Jr Blvd
Tampa, FL 33607-6307

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA211FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baycare Medical Group, Inc CurrentSince Sep 18, 2023 Accepting new patients
American Anesthesiology Services of Florida, Inc. CurrentSince Jun 1, 2018 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Aug 18, 2020 Accepting new patients
Baycare Medical Group, Inc. CurrentSince Sep 18, 2023 Accepting new patients
Baycare Medical Group, Inc. Current Accepting new patients
Sunshine State Anesthesia Partners LLC CurrentSince Feb 28, 2021 Accepting new patients
US Anesthesia Partners of Florida Inc. Anesthesiologist Assistant CurrentSince Jul 15, 2021 Accepting new patients
Gulf-to-Bay Anesthesiology Associates LLC CurrentSince Aug 18, 2020 Accepting new patients

Locations

24040 Tamiami Trl
Bonita Springs, FL 34134
Phone (239) 624-7153

2461 Enterprise Rd
Ste C
Clearwater, FL 33763
Phone (727) 725-5060

300 Pinellas St
Clearwater, FL 33756
Phone (727) 461-8552

700 Medical Blvd
Englewood, FL 34223
Phone (941) 473-5001

2776 Cleveland Ave
Fort Myers, FL 33901
Phone (239) 343-2000

14000 Fivay Rd
Hudson, FL 34667
Phone (727) 819-2929

4725 N Federal Hwy
Oakland Park, FL 33308
Phone (954) 493-5005

15238 Virginia Sta
Odessa, FL 33556
Phone (813) 596-5200

601 E Rollins St
Orlando, FL 32803
Phone (407) 303-1996

21298 Olean Blvd
Pt Charlotte, FL 33952
Phone (941) 624-7032

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

900 Carillon Pkwy
Ste 205
St Petersburg, FL 33716
Phone (727) 561-2710

4016 Sun City Center Blvd
Sun City Ctr, FL 33573
Phone (813) 634-0145

3003 W Mlk Blvd
Tampa, FL 33607
Phone (813) 357-0630

3001 W Mlk Blvd
Tampa, FL 33607
Phone (813) 361-6778

3030 W Mlk Blvd
Tampa, FL 33607
Phone (813) 870-4000

1000 Waterman Way
Tavares, FL 32778
Phone (352) 253-3333

1 Tampa General Cir
University of Tampa, FL 33606
Phone (813) 251-5822

1305 Walt Whitman Rd
Ste 300
Melville, NY 11747
Phone (516) 370-3796

Networks

  • Freedom Health HMO Network

Interoperability endpoints

  • Direct secure messaging: kimberley.boosalesaa@direct.mybaycare.org

Organizations & group practices 8

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1387411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613952000000",
    "number": "1205257136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100254",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100254",
            "telephone_number": "352-273-8610"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3231 MCMULLEN BOOTH RD",
            "city": "SAFETY HARBOR",
            "state": "FL",
            "postal_code": "34695",
            "telephone_number": "727-725-6111"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326103003",
            "country_code": "US",
            "telephone_number": "352-273-8610",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOSALES",
        "first_name": "KIMBERLEY",
        "middle_name": "JEAN",
        "credential": "C-AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-12-19",
        "last_updated": "2021-02-22",
        "certification_date": "2021-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA211",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Safety Harbor, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.