Mrs Tracy Michele Boller, APRN in Stanford, KY

Mrs Tracy Michele Boller, APRN is a medicare enrolled "Nurse Practitioner - Family" in Stanford, Kentucky. Her current practice location is 132 Frontier Blvd Ste 103, Stanford, Kentucky. You can reach out to her office (for appointments etc.) via phone at (859) 287-2949.

Mrs Tracy Michele Boller is licensed to practice in Kentucky (license number 4010008) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1316723539.

Contact Information

	Mrs Tracy Michele Boller, APRN
	132 Frontier Blvd Ste 103, Stanford, KY 40484-6516
	(859) 287-2949
	(855) 297-6367

Map and Direction

Provider's Profile

Full Name	Mrs Tracy Michele Boller
Gender	Female
Speciality	Nurse Practitioner - Family
Location	132 Frontier Blvd Ste 103, Stanford, Kentucky
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1316723539
Provider Enumeration Date: 09/04/2023
Last Update Date: 04/14/2025

Medicare PECOS Information:

PECOS PAC ID: 0749631109
Enrollment ID: I20240110001206

Medical Identifiers

Medical identifiers for Mrs Tracy Michele Boller such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1316723539	NPI	-	NPPES
4010008	Other	KY	KENTUCKY BOARD OF NURSING

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363L00000X	Nurse Practitioner	401008 (Kentucky)	Secondary
363LP2300X	Nurse Practitioner - Primary Care	401008 (Kentucky)	Secondary
363LF0000X	Nurse Practitioner - Family	4010008 (Kentucky)	Primary

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. Mrs Tracy Michele Boller allows following entities to bill medicare on her behalf.

Entity Name	Kiosk Medicine Kentucky Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1205885035 PECOS PAC ID: 6002887510 Enrollment ID: O20040805001127

Entity Name	Lakeside Primary Care Psc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1043790983 PECOS PAC ID: 1153674700 Enrollment ID: O20181120001820

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 Tracy Michele Boller 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 Tracy Michele Boller, APRN 132 Frontier Blvd Ste 103, Stanford, KY 40484-6516 Ph: (859) 287-2949	Mrs Tracy Michele Boller, APRN 132 Frontier Blvd Ste 103, Stanford, KY 40484-6516 Ph: (859) 287-2949

Reviews and Comments

Nurse Practitioner Nurses in Stanford, KY

Kristin Johnsen, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 107 Metker Trl, Suite A, Stanford, KY 40484 Phone: 606-365-8338 Fax: 606-365-8142
Shannah Click, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 135 Wade Owens Rd N, Stanford, KY 40484 Phone: 606-669-6006 Fax: 606-661-0141
Jennifer Merrick, APRN Nurse Practitioner Medicare: May Accept Medicare Assignments Practice Location: 110 Metker Trl, Stanford, KY 40484 Phone: 606-365-3360
Mrs. Jamie Lynn Atwood, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 Jay St, Stanford, KY 40484 Phone: 606-365-1547 Fax: 606-365-8380
Mrs. Jesslyn Brianne Kelsey, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 Jay St, Stanford, KY 40484 Phone: 859-583-7870 Fax: 606-365-8380
Taylor Graves, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 105 Harmon Hts, Stanford, KY 40484 Phone: 606-365-2141 Fax: 606-365-9755

Mrs Tracy Michele Boller, APRN - Medicare Nurse Practitioner in Stanford, KY