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MS. KIMBERLY ELLEN BOLDON NP-C
NPI 1083083638
Nurse Practitioner in Middletown, CT

Active since September 24, 2015PECOS Enrolled
11 S MAIN ST, MIDDLETOWN, CT 06457(860) 347-4555 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

Record update history: Jul 21, 2022, Jul 11, 2017 (2 updates tracked since 2017).

About Ms. Kimberly Ellen Boldon Np-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MS. KIMBERLY ELLEN BOLDON NP-C (NPI 1083083638) is an individual nurse practitioner in Middletown, Connecticut, licensed in Connecticut (6303) and active in the NPI registry since September 2015. She is enrolled in Medicare PECOS and is a graduate of Other (2015).

NPPES Registry Identity

NPI1083083638
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameMS. KIMBERLY ELLEN BOLDONCredential: NP-C
Location Address11 S MAIN STMiddletown, CT 06457-3656
Mailing Address11 S Main StMiddletown, CT 06457-3656 · (860) 347-4555
Phone(860) 347-4555
Sole ProprietorNo
Medical School CMSOtherGraduated 2015
Enumeration DateSeptember 24, 2015
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1083083638 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in CT · 6303
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
11 S MAIN ST, Middletown, CT 06457
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Ms. Kimberly Ellen Boldon Np-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4688974256
PECOS Enrollment IDI20151203002512
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Kimberly Boldon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

The Dermatology Center Of Connecticut, LLC
11 mi
Dermatology
60 CHURCH ST UNIT 4B
Wallingford, CT 06492
  • Reassigned Medicare billing, Connecticut enrollment
  • 2 clinicians in this Medicare group
NPI 1922633213 (203) 907-8474

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
14 services14 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06457 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$93.86 typical visit price
range $60.82 – $183.10
Typical copayment $23.46 (range $15.20 – $45.77)
Most-billed visit code 99203
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 11

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BLUE HILLS BEHAVIORAL HEALTH
Psychiatry & Neurology (Psychiatry)
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 852-3860
DR. MARC DAVID ARONSON M.D.
Psychiatry & Neurology (Psychiatry)
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 347-2366
INTEGRATED DERMATOLOGY OF MIDDLETOWN, PLLC
Dermatology
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 347-4555
MS. WENDY W STOKES APRN
Nurse Practitioner (Psychiatric/Mental Health)
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 344-9063
MIDDLESEX DERMATOLOGY, LLC
Dermatology
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 347-4555
BROOKLYN LARISA MICKOLYZCK DNP, FNP-BC
Nurse Practitioner (Family)
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 347-4555
MELISSA P. DIVITO M.S., LPC
Counselor (Addiction (Substance Use Disorder))
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 704-0300
MRS. DONNA HARVEY RAMAGE LCSW
Counselor (Mental Health)
11 S MAIN ST
MIDDLETOWN, CT 06457
Lower Connecticut River Valley Planning Region (860) 227-8522

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Boldon's NPI number?

The NPI number for Kimberly Boldon is 1083083638. It was assigned to this individual provider in the NPPES registry on September 24, 2015.

Where is Kimberly Boldon located?

Kimberly Boldon practices at 11 S Main St, Middletown, CT 06457. The listed phone number is (860) 347-4555.

What is Kimberly Boldon's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kimberly Boldon enrolled in Medicare?

Yes. Kimberly Boldon is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Kimberly Boldon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kimberly Boldon reassigns Medicare benefits to The Dermatology Center Of Connecticut, LLC (Wallingford, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kimberly Boldon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Kimberly Boldon accept?

Health plans from Anthem Blue Cross and Blue Shield list Kimberly Boldon as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Kimberly Boldon was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.