Mrs Anita Boulom, PA-C in Janesville, WI - Medicare Physician Assistant

Mrs Anita Boulom, PA-C is a medicare enrolled "Physician Assistant" in Janesville, Wisconsin. She went to University Of North Texas Hsc, College Of Osteopathic Med and graduated in 2020 and has 4 years of diverse experience with area of expertise as Physician Assistant. She is a member of the group practice Mercy Health System Corporation and her current practice location is 3400 Deerfield Dr, Janesville, Wisconsin. You can reach out to her office (for appointments etc.) via phone at (608) 314-3600.

Mrs Anita Boulom is licensed to practice in Wisconsin (license number 5192-23) 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 1184213555.

Contact Information

	Mrs Anita Boulom, PA-C
	3400 Deerfield Dr, Janesville, WI 53546-3557
	(608) 314-3600
	Not Available

Map and Direction

Provider's Profile

Full Name	Mrs Anita Boulom
Gender	Female
Speciality	Physician Assistant
Experience	4 Years
Location	3400 Deerfield Dr, Janesville, Wisconsin
Accepts Medicare Assignments	Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.

Medical Education and Training:

Mrs Anita Boulom attended and graduated from University Of North Texas Hsc, College Of Osteopathic Med in 2020

NPI Data:

NPI Number: 1184213555
Provider Enumeration Date: 01/11/2021
Last Update Date: 01/11/2021

Medicare PECOS Information:

PECOS PAC ID: 8921415829
Enrollment ID: I20210319001875

Medical Identifiers

Medical identifiers for Mrs Anita Boulom such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1184213555	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363A00000X	Physician Assistant	5192-23 (Wisconsin)	Primary

Medical Facilities Affiliation

Facility Name	Location	Facility Type
Mercy Health System Corp	Janesville, WI	Hospital

Group Practice Association

Group Practice Name	Group PECOS PAC ID	No. of Members
Mercy Health System Corporation	7416860440	459

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. Mrs Anita Boulom 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
Mrs Anita Boulom, PA-C 700 University Bay Dr Apt 315, Madison, WI 53705-2268 Ph: (469) 348-5497	Mrs Anita Boulom, PA-C 3400 Deerfield Dr, Janesville, WI 53546-3557 Ph: (608) 314-3600

Reviews and Comments

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Mrs Anita Boulom, PA-C - Medicare Physician Assistant in Janesville, WI