KELLY J BOUCHONVILLE PA-C
NPI 1154024586
Physician Assistant in Iowa City, IA

Q: What is Kelly Bouchonville's NPI number?

The NPI number for Kelly Bouchonville is 1154024586. It was assigned to this individual provider in the NPPES registry on March 24, 2023.

Q: What is Kelly Bouchonville's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Active since March 24, 2023PECOS EnrolledAccepts Medicare Assignment

200 HAWKINS DR, IOWA CITY, IA 52242(319) 356-8133(319) 356-2999 Get Directions Write a Review

NPPES record last updated: August 21, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Kelly J Bouchonville Pa-c NPPES

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

KELLY J BOUCHONVILLE PA-C (NPI 1154024586) is an individual physician assistant in Iowa City, Iowa, licensed in Iowa (124548) and active in the NPI registry since March 2023. She is enrolled in Medicare PECOS, is affiliated with University Of Iowa Hospital & Clinics, and is a graduate of Yale University School Of Medicine (2022).

NPPES Registry Identity

NPI1154024586

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameKELLY J BOUCHONVILLECredential: PA-C

Location Address200 HAWKINS DRIowa City, IA 52242-1009

Mailing Address200 Hawkins DrIowa City, IA 52242-1009 · (319) 356-8133 · Fax (319) 356-4600

Phone(319) 356-8133

Fax(319) 356-2999

Sole ProprietorNo

Medical School CMSYale University School Of MedicineGraduated 2022

Enumeration DateMarch 24, 2023

Last NPPES UpdateAugust 21, 2025

NPPES CertifiedAugust 21, 2025

✔ NPI 1154024586 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363A00000X

Licenses✔ Licensed in IA · 124548✔ Licensed in MN · 14257

Definition

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

200 HAWKINS DR, Iowa City, IA 52242

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica, Sanford Health Plan.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelly J Bouchonville Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2567827983

PECOS Enrollment IDI20240509003618

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.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Iowa Hospital & Clinics

Acute Care Hospitals · Iowa City, IA

3/5 CMS rating

OwnershipGovernment - State

CMS Certification Number160058

Location200 Hawkins DriveIowa City, IA 52242 · Johnson County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 52242 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

$81.84 typical visit price

range $52.96 – $161.40

Typical copayment $20.46 (range $13.24 – $40.35)

Most-billed visit code 99203

Established Patient

$66.36 typical visit price

range $16.91 – $131.98

Typical copayment $16.59 (range $4.22 – $32.99)

Most-billed visit code 99213

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 20

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

SANGIL LEE M.D.

Emergency Medicine

200 HAWKINS DR
IOWA CITY, IA 52242

Johnson County (319) 356-2233

RAMI G. EL ABIAD M.D.

Internal Medicine (Gastroenterology)

200 HAWKINS DR
IOWA CITY, IA 52242

Johnson County (319) 356-4901

GRERK SUTAMTEWAGUL MD

Internal Medicine (Hematology & Oncology)

200 HAWKINS DR, DEPT OF INTERNAL MEDICINE
IOWA CITY, IA 52242

Johnson County (319) 356-1616

DR. KALEB TANNER VEIT D.O.

Internal Medicine (Critical Care Medicine)

200 HAWKINS DR
IOWA CITY, IA 52242

Johnson County (319) 356-2320

OMAR JABER M.D

Chronic Disease Hospital

200 HAWKINS DR
IOWA CITY, IA 52242

Johnson County (319) 471-8958

JENNIFER MANCUSO MS, CGC

Genetic Counselor, MS

200 HAWKINS DR, 31663 PFP
IOWA CITY, IA 52242

Johnson County (319) 384-7983

ASHLEY KAISER M.D.

Obstetrics & Gynecology

200 HAWKINS DR, DEPT OF OBGYN
IOWA CITY, IA 52242

Johnson County (319) 356-2294

MRS. NANCY JANE MILLICE

Health Educator

200 HAWKINS DR, 0733 JPP
IOWA CITY, IA 52242

Johnson County (319) 356-3825

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 Kelly Bouchonville's NPI number?

The NPI number for Kelly Bouchonville is 1154024586. It was assigned to this individual provider in the NPPES registry on March 24, 2023.

Where is Kelly Bouchonville located?

Kelly Bouchonville practices at 200 Hawkins Dr, Iowa City, IA 52242. The listed phone number is (319) 356-8133.

What is Kelly Bouchonville's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Kelly Bouchonville enrolled in Medicare?

Yes. Kelly Bouchonville is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Kelly Bouchonville accept?

Health plans from Medica and Sanford Health Plan list Kelly Bouchonville 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.

Is Kelly Bouchonville affiliated with any hospitals?

According to CMS data, Kelly Bouchonville is affiliated with University Of Iowa Hospital & Clinics.

When was this NPI record last updated?

The NPPES record for Kelly Bouchonville was last updated on August 21, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months 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.