Kathleen M. Boettcher, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6565 Issued in GA

Practice address

3970 Deputy Bill Cantrel Memoiral Rd
Cumming, GA 30040

Phone

(678) 513-2273

Fax

(678) 513-8869

NPI assigned

Jul 21, 2005

Last updated

Sep 2, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Heart and Vascular Care, LLCGroup PAC ID 0941303622, 45 clinicians

Heart and Vascular Care East LLCGroup PAC ID 2163951997, 20 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005

Merit-based Incentive Payment System (MIPS)

Final score

89.65 of 100Reported as group

Quality

90.12

Promoting interoperability

100

Improvement activities

40

Cost

75.39

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kathleen.boettcher.1@1164.direct.athenahealth.com

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.

• Heart and Vascular Care East, LLC

  • Cardiovascular Disease Physician
  • Cumming, GA
  • NPI 1205651510
  Medicare reassignment Care Compare group NPD
• Heart and Vascular Care, LLC

  • Cardiovascular Disease Physician
  • Cumming, GA
  • NPI 1144371576
  Medicare reassignment Care Compare group NPD
• Cardiovascular Associates of Wisconsin, LLP

  • Cardiovascular Disease Physician
  • Milwaukee, WI
  • NPI 1841286291
  NPD (past)

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

• Northside Hospital, Inc.

  dba Northside Hospital Forsyth

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation

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

{
    "created_epoch": "1121904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1472774400000",
    "number": "1669472551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3970 DEPUTY BILL CANTREL MEMOIRAL RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "678-513-2273",
            "fax_number": "678-513-8869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3970 DEPUTY BILL CANTREL MEMOIRAL RD",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30040",
            "telephone_number": "678-513-2273",
            "fax_number": "678-513-8869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOETTCHER",
        "first_name": "KATHLEEN",
        "middle_name": "M.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-21",
        "last_updated": "2016-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-00745",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WI",
            "license": "1775-023",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "GA",
            "license": "6565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• BNB Human Services
• Bob G. Lanier, MD, PC
• Tamiya Bobb
• Gianna Valentina Bochicchio, AEMT
• Bodyset Inc (North Atlanta Vertigo & Physical Therapy)
• Emma Bohnet
• Aaron B Bolds, MD, MBA
• Barbara E Boling, M.D.
• James Fred Boling, M.D.
• William Boling, M.D.

• Medical Physician Assistant in Cumming, GA
• Providers in Cumming, GA by specialty
• Medical Physician Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; 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.
• 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.