Kimberly Bousema, PA is a medicare enrolled "Physician Assistant" in Rensselaer, Indiana. She graduated from nursing school in 2024 and has 2 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Franciscan Physician Network and her current practice location is
1103 E Grace St, Rensselaer, Indiana. You can reach out to her office (for appointments etc.) via phone at
(219) 866-0411.
Kimberly Bousema is licensed to practice in Indiana (license number 10004742A) 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 1629819826.
Provider's Profile
| Full Name | Kimberly Bousema |
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| Gender | Female |
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| Speciality | Physician Assistant |
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| Experience | 2 Years |
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| Location | 1103 E Grace St, Rensselaer, Indiana |
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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:
- Kimberly Bousema graduated from nursing school in 2024
NPI Data:
- NPI Number: 1629819826
- Provider Enumeration Date: 06/03/2024
- Last Update Date: 03/07/2025
Medicare PECOS Information:
- PECOS PAC ID: 5193247112
- Enrollment ID: I20250319003494
Medical Identifiers
Medical identifiers for Kimberly Bousema such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1629819826 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363A00000X | Physician Assistant | 10004742A (Indiana) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (* (Not Available)) | Secondary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Franciscan Physician Network | 3072790682 | 1041 |
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. Kimberly Bousema 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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Kimberly Bousema, PA
Po Box 781076,
Detroit, MI 48278-1076
Ph: (317) 528-4800 | Kimberly Bousema, PA
1103 E Grace St,
Rensselaer, IN 47978-3251
Ph: (219) 866-0411 |
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