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KIMBERLY BOUSEMA PA
NPI 1629819826
Physician Assistant in Rensselaer, IN

Active since June 03, 2024PECOS EnrolledAccepts Medicare Assignment
1103 E GRACE ST, RENSSELAER, IN 47978(219) 866-0411(219) 866-1920 Get Directions Write a Review

NPPES record last updated: March 7, 2025. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Mar 7, 2025, Dec 9, 2024, Jun 27, 2024 and 1 more (4 updates tracked since 2024).

About Kimberly Bousema Pa NPPES

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

KIMBERLY BOUSEMA PA (NPI 1629819826) is an individual physician assistant in Rensselaer, Indiana, licensed in Indiana (10004742A) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS, is affiliated with Franciscan Health Rensselaer, Inc, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1629819826
Entity TypeIndividualFemale
Primary Taxonomy363A00000X
Provider Legal NameKIMBERLY BOUSEMACredential: PA
Location Address1103 E GRACE STRensselaer, IN 47978-3251
Mailing AddressPo Box 781076Detroit, MI 48278-1076 · (317) 528-4800 · Fax (317) 865-1479
Phone(219) 866-0411
Fax(219) 866-1920
Sole ProprietorYes
Medical School CMSOtherGraduated 2024
Enumeration DateJune 3, 2024
Last NPPES UpdateMarch 7, 20254 updates tracked since enumeration
NPPES CertifiedMarch 7, 2025
✔ NPI 1629819826 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License✔ Licensed in IN · 10004742A
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.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
1103 E GRACE ST, Rensselaer, IN 47978
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Buckeye Health Plan, Ambetter from Meridian, Ambetter Health and more.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

Kimberly Bousema Pa 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 ID5193247112
PECOS Enrollment IDI20250319003494
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.

Franciscan Health Rensselaer, Inc

Critical Access Hospitals · Rensselaer, IN
OwnershipVoluntary non-profit - Private
CMS Certification Number151324
Location1104 E Grace StRensselaer, IN 47978 · Jasper County
Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 47978 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
$82.04 typical visit price
range $53.07 – $161.76
Typical copayment $20.51 (range $13.26 – $40.44)
Most-billed visit code 99203
Established Patient
$66.48 typical visit price
range $16.93 – $132.22
Typical copayment $16.62 (range $4.23 – $33.05)
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 3

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

WALTER L CURRY DPM
Podiatrist
1103 E GRACE ST
RENSSELAER, IN 47978
Jasper County (219) 866-5596
LIBERTY CLINIC LLC
Clinic/Center (Multi-Specialty)
1103 E GRACE ST
RENSSELAER, IN 47978
Jasper County (219) 866-4135
DR. STEPHEN CHARLES SPICER M.D.
Family Medicine
1103 E GRACE ST
RENSSELAER, IN 47978
Jasper County (219) 866-4135

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 Bousema's NPI number?

The NPI number for Kimberly Bousema is 1629819826. It was assigned to this individual provider in the NPPES registry on June 3, 2024.

Where is Kimberly Bousema located?

Kimberly Bousema practices at 1103 E Grace St, Rensselaer, IN 47978. The listed phone number is (219) 866-0411.

What is Kimberly Bousema's specialty?

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

Is Kimberly Bousema enrolled in Medicare?

Yes. Kimberly Bousema 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 Kimberly Bousema accept?

Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian and CareSource list Kimberly Bousema 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 Kimberly Bousema affiliated with any hospitals?

According to CMS data, Kimberly Bousema is affiliated with Franciscan Health Rensselaer, Inc.

When was this NPI record last updated?

The NPPES record for Kimberly Bousema was last updated on March 7, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.