Active NPI
Kristen M Boyd, PA
- Medical Physician Assistant
- Muskego, WI
National Provider Identifier
1891952503
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Medical Physician Assistant
- License
- 2546-23
- Practice address
- S69W15636 Janesville Rd
Muskego, WI 53150-9330 - Phone
- (262) 928-7000
- NPI assigned
- May 20, 2008
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Medical Physician Assistant | 363AM0700X | 085002664 | IL | |
| Medical Physician Assistant | 363AM0700X | 2546-23 | WI | Primary |
Addresses
Primary practice location
S69W15636 Janesville Rd
Muskego, WI 53150-9330
Mailing address
S69W15636 Janesville Rd
Muskego, WI 53150-9330
Phone (262) 928-7000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 085002664 | IL | MD | Medical Physician Assistant |
| 2546-23 | WI | MD | Medical Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Prohealth Medical Group Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Family Medicine Physician
- Waukesha, WI
- NPI 1790720613
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1211241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1278979200000",
"number": "1891952503",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "S69W15636 JANESVILLE RD",
"city": "MUSKEGO",
"state": "WI",
"postal_code": "531509330",
"telephone_number": "262-928-7000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "S69W15636 JANESVILLE RD",
"city": "MUSKEGO",
"state": "WI",
"postal_code": "531509330",
"telephone_number": "262-928-7000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYD",
"first_name": "KRISTEN",
"middle_name": "M",
"credential": "PA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-05-20",
"last_updated": "2010-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "IL",
"license": "085002664",
"primary": false
},
{
"code": "363AM0700X",
"taxonomy_group": "",
"desc": "Physician Assistant, Medical",
"state": "WI",
"license": "2546-23",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Muskego, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.