Dr Kenneth Jerome Boomgaard, MD is a medicare enrolled "Family Medicine" physician in Elmendorf Afb, Alaska. He went to Wayne State University School Of Medicine and graduated in 1995 and has 29 years of diverse experience with area of expertise as Family Practice. He is a member of the group practice Aa Pain Clinic, Inc., Select Physical Therapy Holdings Inc and his current practice location is
3rd Medical Group, Elmendorf Regional Medical Center, 5955 Zeamer Ave, Elmendorf Afb, Alaska. You can reach out to his office (for appointments etc.) via phone at
(907) 580-2956.
Dr Kenneth Jerome Boomgaard is licensed to practice in Michigan (license number 4301071073) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1427047034.
Physician's Profile
| Full Name | Dr Kenneth Jerome Boomgaard |
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| Gender | Male |
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| Speciality | Family Practice |
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| Experience | 29 Years |
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| Location | 3rd Medical Group, Elmendorf Regional Medical Center, Elmendorf Afb, Alaska |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Kenneth Jerome Boomgaard attended and graduated from Wayne State University School Of Medicine in 1995
NPI Data:
- NPI Number: 1427047034
- Provider Enumeration Date: 10/17/2005
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 9436331840
- Enrollment ID: I20110307000506
Medical Identifiers
Medical identifiers for Dr Kenneth Jerome Boomgaard such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1427047034 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207Q00000X | Family Medicine | 4301071073 (Michigan) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Aa Pain Clinic, Inc. | 7911892443 | 11 |
| Select Physical Therapy Holdings Inc | 9537076401 | 1487 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Kenneth Jerome Boomgaard allows following entities to bill medicare on his behalf.
| Entity Name | Aa Pain Clinic, Inc. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1972596633
PECOS PAC ID: 7911892443
Enrollment ID: O20040216000359 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Kenneth Jerome Boomgaard is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Kenneth Jerome Boomgaard, MD
21950 Sheltering Spruce Loop,
Chugiak, AK 99567-5402
Ph: (907) 688-7826 | Dr Kenneth Jerome Boomgaard, MD
3rd Medical Group, Elmendorf Regional Medical Center, 5955 Zeamer Ave,
Elmendorf Afb, AK 99506-3700
Ph: (907) 580-2956 |
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