MARIE VALE BOOMER PA-C
NPI 1164621009
Physician Assistant - Medical in Novi, MI

Q: What is Marie Boomer's NPI number?

The NPI number for Marie Boomer is 1164621009. It was assigned to this individual provider in the NPPES registry on July 12, 2007.

Q: What is Marie Boomer's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Q: When was this NPI record last updated?

The NPPES record for Marie Boomer was last updated on December 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.

Active since July 12, 2007

28455 HAGGERTY RD, STE 200, NOVI, MI 48377(248) 893-3200(248) 893-2950 Get Directions Write a Review

NPPES record last updated: December 29, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

On this page

About Marie Vale Boomer Pa-c NPPES

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

MARIE VALE BOOMER PA-C (NPI 1164621009) is an individual medical provider in Novi, Michigan, licensed in Michigan (5601001569) and active in the NPI registry since July 2007.

NPPES Registry Identity

NPI1164621009

Entity TypeIndividualFemale

Primary Taxonomy363AM0700X

Provider Legal NameMARIE VALE BOOMERCredential: PA-C

Location Address28455 HAGGERTY RD, STE 200Novi, MI 48377-2982

Mailing Address6676 Solutions CtrChicago, IL 60677-6006 · (248) 893-3200 · Fax (248) 893-2951

Phone(248) 893-3200

Fax(248) 893-2950

Sole ProprietorNo

Enumeration DateJuly 12, 2007

Last NPPES UpdateDecember 29, 2015

✔ NPI 1164621009 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363AM0700X

License✔ Licensed in MI · 5601001569

28455 HAGGERTY RD, Novi, MI 48377

Open in Google Maps ↗

Other Identifiers 1

Medicare PIN0Q26007070MI

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.

WOLVERINE ORTHOTICS, INC.

Orthotist

28455 HAGGERTY RD, 101
NOVI, MI 48377

Oakland County (248) 324-3010

MICHAEL J ELLENBERG MD

Physical Medicine & Rehabilitation

28455 HAGGERTY RD, 200
NOVI, MI 48377

Oakland County (248) 893-3200

MR. MAURY RUBEN ELLENBERG MD

Physical Medicine & Rehabilitation

28455 HAGGERTY RD, SUITE 200
NOVI, MI 48377

Oakland County (248) 893-3200

DANIELLE M BESSESEN NP

Nurse Practitioner (Primary Care)

28455 HAGGERTY RD, STE 200
NOVI, MI 48377

Oakland County (248) 893-3200

LALITHA RAMAMOORTHY MS, RD

Dietitian, Registered

28455 HAGGERTY RD
NOVI, MI 48377

Oakland County (248) 553-0050

DR. JEANETTE GLUSZEWSKI -SAUER MD

Physical Medicine & Rehabilitation

28455 HAGGERTY RD, STE 200
NOVI, MI 48377

Oakland County (248) 893-3200

ELIZABETH M HALL MD

Physical Medicine & Rehabilitation

28455 HAGGERTY RD, SUITE 200
NOVI, MI 48377

Oakland County (248) 893-3200

DR. STEPHEN CRAIG HYMAN MD

Physical Medicine & Rehabilitation

28455 HAGGERTY RD, SUITE 200
NOVI, MI 48377

Oakland County (248) 893-3200

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 Marie Boomer's NPI number?

The NPI number for Marie Boomer is 1164621009. It was assigned to this individual provider in the NPPES registry on July 12, 2007.

Where is Marie Boomer located?

Marie Boomer practices at 28455 Haggerty Rd Ste 200, Novi, MI 48377. The listed phone number is (248) 893-3200.

What is Marie Boomer's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

When was this NPI record last updated?

The NPPES record for Marie Boomer was last updated on December 29, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.