Individual provider Active NPI

Kelly Frances Boeing, PA

  • Physician Assistant
  • Leavenworth, WA
National Provider Identifier
1861746505
Registry record updated Jul 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA160585 Issued in OR
Practice address
817 Commercial St
Leavenworth, WA 98826-1316
Phone
(509) 548-3420
NPI assigned
Nov 2, 2012
Last updated
Jul 10, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 10, 2019

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 PA160585 OR Primary

Addresses

Primary practice location

817 Commercial St
Leavenworth, WA 98826-1316

Mailing address

817 Commercial St
Leavenworth, WA 98826-1316
Phone (095) 483-4205

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
I20170816003927 WA Practitioner - Physician Assistant 5991957078 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

817 Commercial St
Leavenworth, WA 98826-1316
Phone (509) 548-3420

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Chelan County Public Hospital District No. 1 CurrentSince Jul 25, 2017 Accepting new patients
Chelan County Public Hospital District No. 1 CurrentSince Jul 25, 2017 Accepting new patients

Locations

817 Commercial St
Leavenworth, WA 98826
Phone (509) 548-3420

Organizations & group practices 2

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 3

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": "1351814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562716800000",
    "number": "1861746505",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 COMMERCIAL ST",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988261316",
            "telephone_number": "095-483-4205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 COMMERCIAL ST",
            "city": "LEAVENWORTH",
            "state": "WA",
            "postal_code": "988261316",
            "telephone_number": "509-548-3420"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEING",
        "first_name": "KELLY",
        "middle_name": "FRANCES",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-11-02",
        "last_updated": "2019-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OR",
            "license": "PA160585",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leavenworth, WA

Sources for this page

Verify at the official NPI Registry.