Brandan Conice Boenicke, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA02104 Issued in TX

Practice address

1801 N Bedell Ave
Del Rio, TX 78840-8001

Phone

(830) 768-9200

NPI assigned

Jan 25, 2006

Last updated

Jun 11, 2013By the provider in NPPES

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 TX

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

Specialty

Physician Assistant

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Val Verde Hospital CorporationGroup PAC ID 0941112023, 39 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Resource Home Health Services Home health agency, Houston, TX, CCN 679098
• Home Care Providers of Texas Home health agency, Dallas, TX, CCN 453157
• American Medical Home Health Services - San Antonio LLC Home health agency, San Antonio, TX, CCN 457907
• Acara Home health agency, San Antonio, TX, CCN 747169
• Val Verde Regional Medical Center Hospital, Del Rio, TX, CCN 450154

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: brandanboenicke@valverde.medalliesdirect.net

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.

• Val Verde Hospital Corporation

  • Certified Registered Nurse Anesthetist
  • Del Rio, TX
  • NPI 1639239239
  Medicare reassignment Care Compare group
• Val Verde Hospital Corporation

  dba Terry M. Lindsey Rural Health Clinic

  • Rural Health Clinic/Center
  • Del Rio, TX
  • NPI 1093546590
  NPD
• Val Verde Hospital Corporation

  • Surgery Physician
  • Del Rio, TX
  • NPI 1730851585
  NPD
• Val Verde Hospital Corporation

  dba Val Verde Regional Medical Center Rural Health Clinic

  • Rural Health Clinic/Center
  • Del Rio, TX
  • NPI 1891124640
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• American Medical Home Health Services - San Antonio LLC

  • Home Health Agency
  • San Antonio, TX
  • NPI 1295788289
  Care Compare affiliation
• Axiom Home Health LLC

  dba Acara

  • Home Health Agency
  • San Antonio, TX
  • NPI 1679583777
  Care Compare affiliation
• DPP II, LLC

  dba Home Care Providers of Texas

  • Home Health Agency
  • Dallas, TX
  • NPI 1013992692
  Care Compare affiliation
• Resource Health Services Inc

  dba Resource Home Health Services

  • Home Health Agency
  • Houston, TX
  • NPI 1629179346
  Care Compare affiliation
• Val Verde Hospital Corporation

  dba Val Verde Regional Medical Center

  • General Acute Care Hospital
  • Del Rio, TX
  • NPI 1104830900
  Care Compare affiliation

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

{
    "created_epoch": "1138147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1942270723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 437",
            "city": "SAN ANTONIO",
            "state": "TX",
            "postal_code": "782920437",
            "telephone_number": "210-558-6288",
            "fax_number": "210-558-6289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 N BEDELL AVE",
            "city": "DEL RIO",
            "state": "TX",
            "postal_code": "788408001",
            "telephone_number": "830-768-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOENICKE",
        "first_name": "BRANDAN",
        "middle_name": "CONICE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-25",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA02104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bio-Medical Applications of Texas, Inc. (Fresenius Medical Care Val Verde Dialysis Center)
• Rebecca Ann Blackstone, R.PH.
• Stanley Blackstone, RPH.
• Stephanie Blancarte, LCSW
• Raymond Keith Blottin, LPC
• Jamie Garcia Bonnes, FNP-BC
• Brian C. Bonser, PA-C
• Hannah L Booth, MS, CCC-SLP
• Borderland Home Health Care
• Jose Guadalupe Briones, OPTICIAN

• Physician Assistant in Del Rio, TX
• Providers in Del Rio, TX by specialty
• Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.