Kylie Mariah Boogaard

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

414 Zeagler Dr
Palatka, FL 32177-3815

Phone

(386) 328-4123

NPI assigned

Jul 11, 2018

Last updated

Feb 23, 2023By 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 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in SC

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

Interoperability endpoints

• Direct secure messaging: kylie.schrade@hca5.eclinicaldirectplus.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.

• Acs Primary Care Physicians - Southeast PC

  • Emergency Medicine Physician
  • Myrtle Beach, SC
  • NPI 1861430555
  Medicare reassignment

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

{
    "created_epoch": "1531267200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677110400000",
    "number": "1871079905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "265 BROOKVIEW CENTRE WAY STE 400",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379194052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 ZEAGLER DR",
            "city": "PALATKA",
            "state": "FL",
            "postal_code": "321773815",
            "telephone_number": "386-328-4123"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4000 Highway 9 E",
            "address_purpose": "LOCATION",
            "city": "Little River",
            "state": "SC",
            "postal_code": "295667833",
            "country_code": "US",
            "telephone_number": "843-390-8100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3655 Mitchell St",
            "address_purpose": "LOCATION",
            "city": "Loris",
            "state": "SC",
            "postal_code": "295692827",
            "country_code": "US",
            "telephone_number": "843-716-7000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "107 McLeod Health Blvd",
            "address_purpose": "LOCATION",
            "city": "Myrtle Beach",
            "state": "SC",
            "postal_code": "295794477",
            "country_code": "US",
            "telephone_number": "843-646-8200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOOGAARD",
        "first_name": "KYLIE",
        "middle_name": "MARIAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-07-11",
        "last_updated": "2023-02-23",
        "certification_date": "2023-02-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "KYLIE.SCHRADE@hca5.eclinicaldirectplus.com",
            "affiliation": "N",
            "address_1": "414 Zeagler Dr",
            "city": "Palatka",
            "state": "FL",
            "country_code": "US",
            "postal_code": "321773815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bonnie Louise Bird-Loeffler, LMT
• Blessed Loving Hands Homecare
• Body Mechanics Therapy Incorporated
• Derek Bohn, M.D.
• Angel M Bonet, MD
• Michael Arthur Borelli, MD
• Jolly Bose, M.D.
• Kashanti Shanti Bowden, NP
• Rod Bowen, LMT
• Melissa Faye Bowman, PTA

• Surgical Physician Assistant in Palatka, FL
• Providers in Palatka, FL by specialty
• Surgical Physician Assistant in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2023; 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.