Kelly K Boland, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Concord Township, Ohio. She graduated from nursing school in 1997 and has 29 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Dayton Gastroenterology, Llc and her current practice location is
9614 Old Johnnycake Ridge Rd, Concord Township, Ohio. You can reach out to her office (for appointments etc.) via phone at
(440) 205-1225.
Kelly K Boland is licensed to practice in Ohio (license number APRN.CRNA.04981) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1770556391.
Provider's Profile
| Full Name | Kelly K Boland |
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| Gender | Female |
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| Speciality | Certified Registered Nurse Anesthetist (crna) |
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| Experience | 29 Years |
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| Location | 9614 Old Johnnycake Ridge Rd, Concord Township, Ohio |
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| Accepts Medicare Assignments | Yes. She 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:
- Kelly K Boland graduated from nursing school in 1997
NPI Data:
- NPI Number: 1770556391
- Provider Enumeration Date: 02/13/2006
- Last Update Date: 02/19/2026
Medicare PECOS Information:
- PECOS PAC ID: 0547352403
- Enrollment ID: I20071105000362
Medical Identifiers
Medical identifiers for Kelly K Boland such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1770556391 | NPI | - | NPPES |
| 2181491 | Medicaid | OH | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 367500000X | Nurse Anesthetist, Certified Registered | APRN.CRNA.04981 (Ohio) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Dayton Gastroenterology, Llc | 9537064407 | 74 |
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. Kelly K Boland allows following entities to bill medicare on her behalf.
| Entity Name | Dayton Gastroenterology, LLC |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1134345705
PECOS PAC ID: 9537064407
Enrollment ID: O20031204000041 |
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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. Kelly K Boland 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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Kelly K Boland, CRNA
Po Box 381468,
Germantown, TN 38183-1468
Ph: Not Available | Kelly K Boland, CRNA
9614 Old Johnnycake Ridge Rd,
Concord Township, OH 44060-6521
Ph: (440) 205-1225 |
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