Kenzi Lee Boman, is a medicare enrolled "Nurse Practitioner" physician in Tampa, Florida. Her current practice location is
14502 N Dale Mabry Hwy Ste 200, Tampa, Florida. You can reach out to her office (for appointments etc.) via phone at
(801) 663-6195.
Kenzi Lee Boman is licensed to practice in Florida (license number APRN11025232) 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 1275235590.
Physician's Profile
Full Name | Kenzi Lee Boman |
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Gender | Female |
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Speciality | Nurse Practitioner |
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Location | 14502 N Dale Mabry Hwy Ste 200, Tampa, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1275235590
- Provider Enumeration Date: 03/20/2023
- Last Update Date: 02/12/2024
Medicare PECOS Information:
- PECOS PAC ID: 3072988286
- Enrollment ID: I20230331000086
Medical Identifiers
Medical identifiers for Kenzi Lee Boman such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1275235590 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208D00000X | General Practice | 11025232 (Florida) | Secondary |
363L00000X | Nurse Practitioner | APRN11025232 (Florida) | 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. Kenzi Lee Boman allows following entities to bill medicare on her behalf.
Entity Name | Honestar Wound Care Pllc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1174247811 PECOS PAC ID: 9638545817 Enrollment ID: O20221012002914 |
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Entity Name | Spencer J Hardenbrook Md Pc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1073909594 PECOS PAC ID: 2062733546 Enrollment ID: O20240430004152 |
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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. Kenzi Lee Boman 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 |
Kenzi Lee Boman, 211 Roseling Xing, Davenport, FL 33897-3858 Ph: (801) 663-6195 | Kenzi Lee Boman, 14502 N Dale Mabry Hwy Ste 200, Tampa, FL 33618-2040 Ph: (801) 663-6195 |
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