Individual provider Active NPI

Ginger Bouma, MD

  • Physician Assistant
  • Poulsbo, WA
National Provider Identifier
1679507289
Registry record updated Aug 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10004612 Issued in WA
Practice address
21800 Marketplace NW Ste 103
Poulsbo, WA 98370-6667
Phone
(360) 291-5700
Fax
(360) 637-0863
NPI assigned
Jul 10, 2006
Last updated
Aug 18, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10004612 WA Primary
Dermatology Physician 207N00000X PA10004612 WA
Procedural Dermatology Physician 207NS0135X PA1004612 WA

Addresses

Primary practice location

21800 Marketplace NW Ste 103
Poulsbo, WA 98370-6667

Mailing address

21800 Marketplace NW Ste 103
Poulsbo, WA 98370-6667
Phone (360) 291-5700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
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
I20040503000978 WA Practitioner - Physician Assistant 0840288585 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

21800 Market PL NW
Suite 103
Poulsbo, WA 98370-6667
Phone (360) 291-5700

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.44 of 100Reported as group
Quality
93.64
Improvement activities
40
Cost
83.29

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10004612WAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
North Pacific Dermatology Services, LLC Dermatology Past Accepting new patients
North Pacific Dermatology PS Past Accepting new patients

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787011200000",
    "number": "1679507289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21800 MARKETPLACE NW STE 103",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706667",
            "telephone_number": "360-291-5700",
            "fax_number": "360-637-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21800 MARKETPLACE NW STE 103",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983706667",
            "telephone_number": "360-291-5700",
            "fax_number": "360-637-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUMA",
        "first_name": "GINGER",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-10",
        "last_updated": "2026-08-18",
        "certification_date": "2026-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "PA10004612",
            "primary": true
        },
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "WA",
            "license": "PA10004612",
            "primary": false
        },
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "WA",
            "license": "PA1004612",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

Verify at the official NPI Registry.