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JEFFERSON L BOULET PAC
NPI 1740274745
Physician Assistant - Medical in Buckley, WA

Active since September 06, 2005PECOS EnrolledAccepts Medicare Assignment
305 N RIVER AVE, BUCKLEY, WA 98321(360) 829-0625(360) 829-9860 Get Directions Write a Review

NPPES record last updated: March 7, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Jefferson L Boulet Pac NPPES

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

JEFFERSON L BOULET PAC (NPI 1740274745) is an individual medical provider in Buckley, Washington, licensed in Washington (PA10003567) and active in the NPI registry since September 2005. He is enrolled in Medicare PECOS, is affiliated with St Joseph Medical Center, and is a graduate of Other (1997).

NPPES Registry Identity

NPI1740274745
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameJEFFERSON L BOULETCredential: PAC
Location Address305 N RIVER AVEBuckley, WA 98321-8978
Mailing AddressPo Box 1268Buckley, WA 98321-1268 · (360) 829-0625 · Fax (360) 829-9860
Phone(360) 829-0625
Fax(360) 829-9860
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateSeptember 6, 2005
Last NPPES UpdateMarch 7, 2023
✔ NPI 1740274745 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 WA · PA10003567
305 N RIVER AVE, Buckley, WA 98321
Open in Google Maps ↗

Other Identifiers 1

Medicaid8542300WA

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska, Providence 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

Jefferson L Boulet Pac 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 ID4688700974
PECOS Enrollment IDI20100325000615
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.

Areas of Expertise CMS Part B claims 8

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.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
288 services117 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
234 services92 patients
Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301
Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.
178 services29 patients
Insertion of needle into vein for collection of blood sample 36415
This procedure involves inserting a small needle into a vein, typically in your arm, to collect a blood sample. It's a quick and simple process to help diagnose or monitor health conditions. You may feel a small prick, but discomfort is minimal.
82 services74 patients
Aspiration and/or injection of fluid from large joint 20610
This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.
23 services15 patients
Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439
An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.
21 services21 patients

Hospital Affiliations CMS Care Compare 3

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

St Joseph Medical Center

Acute Care Hospitals · Tacoma, WA
4/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number500108
Location1717 South J StreetTacoma, WA 98405 · Pierce County
Emergency services Birthing friendly

Tacoma General Allenmore Hospital

Acute Care Hospitals · Tacoma, WA
2/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500129
Location315 S Mlk Jr WayTacoma, WA 98405 · Pierce County
Emergency services Birthing friendly

St Elizabeth Hospital

Critical Access Hospitals · Enumclaw, WA
OwnershipVoluntary non-profit - Private
CMS Certification Number501335
Location1450 Battersby AvenueEnumclaw, WA 98022 · King County
Emergency services Birthing friendly

Referred Medical Equipment & Supplies CMS DME claims 2

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
4 suppliers18 claims51 services$5.51 avg. paid by Medicare
Continuous positive airway pressure (cpap) device E0601
DME-Other DME · category DE001N
1 supplier16 claims16 services$25.56 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

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

MICHAEL A WELSH MD
Family Medicine
305 N RIVER AVE
BUCKLEY, WA 98321
Pierce County (360) 829-0625

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 Jefferson Boulet's NPI number?

The NPI number for Jefferson Boulet is 1740274745. It was assigned to this individual provider in the NPPES registry on September 6, 2005.

Where is Jefferson Boulet located?

Jefferson Boulet practices at 305 N River Ave, Buckley, WA 98321. The listed phone number is (360) 829-0625.

What is Jefferson Boulet's specialty?

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

Is Jefferson Boulet enrolled in Medicare?

Yes. Jefferson Boulet 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 Jefferson Boulet accept?

Health plans from PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Jefferson Boulet 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 Jefferson Boulet affiliated with any hospitals?

According to CMS data, Jefferson Boulet is affiliated with St Joseph Medical Center, Tacoma General Allenmore Hospital and St Elizabeth Hospital.

When was this NPI record last updated?

The NPPES record for Jefferson Boulet was last updated on March 7, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.