Kylan Boehlke, CPNP-AC, MS, RN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

95012473 Issued in CA

Practice address

725 Welch Rd
Palo Alto, CA 94304-1601

Phone

(650) 497-8000

NPI assigned

Sep 30, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

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

Credentials

Master of Science, Nurse Practitioner, Registered Nurse

State licenses

Practice roles

Locations

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.

• LPCH Medical Group Div of Lucile

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940
  Medicare reassignment NPD
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  Medicare reassignment NPD
• Stanford Health Care

  • Specialty Pharmacy
  • Mountain View, CA
  • NPI 1760366132
  NPD

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

{
    "created_epoch": "1569801600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720569600000",
    "number": "1902447055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 WELCH RD",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943041601",
            "telephone_number": "650-497-8000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEHLKE",
        "first_name": "KYLAN",
        "credential": "CPNP-AC, MS, RN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-30",
        "last_updated": "2024-07-10",
        "certification_date": "2024-07-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "CA",
            "license": "95012473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert Bocian, M.D.
• Monica Himaani Bodd, MD
• Mark Gordon Boddy, MD
• Jessica Farley Bode
• Body Kneads Day Spa
• Lawrence W Boehm, CMT
• Susan Boehm, CMT
• Teresa Christine Boehm, CTRS
• Yuk Boekenoogen
• Alina Margaret Boelman, M.D.

• Nurse Practitioner in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 10, 2024; 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.