JENNIFER BOOMER APN
NPI 1861901316
Nurse Practitioner - Family in Rockford, IL

Q: What is Jennifer Boomer's NPI number?

The NPI number for Jennifer Boomer is 1861901316. It was assigned to this individual provider in the NPPES registry on September 28, 2017.

Q: What is Jennifer Boomer's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Boomer was last updated on September 28, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 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 September 28, 2017PECOS EnrolledAccepts Medicare Assignment

2400 N ROCKTON AVE, ROCKFORD, IL 61103(815) 971-5000 Get Directions Write a Review

NPPES record last updated: September 28, 2017. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Jennifer Boomer Apn NPPES

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

JENNIFER BOOMER APN (NPI 1861901316) is an individual family provider in Rockford, Illinois, licensed in Illinois (209016612) and active in the NPI registry since September 2017. She is enrolled in Medicare PECOS, is affiliated with Javon Bea Hospital, and is a graduate of Other (2017).

NPPES Registry Identity

NPI1861901316

Entity TypeIndividualFemale

Primary Taxonomy363LF0000X

Provider Legal NameJENNIFER BOOMERCredential: APN

Location Address2400 N ROCKTON AVERockford, IL 61103-3655

Mailing Address2400 N Rockton AveRockford, IL 61103-3655

Phone(815) 971-5000

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateSeptember 28, 2017

✔ NPI 1861901316 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LF0000X

License✔ Licensed in IL · 209016612

2400 N ROCKTON AVE, Rockford, IL 61103

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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

Jennifer Boomer Apn 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 ID6204193204

PECOS Enrollment IDI20171129002382

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 2

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.

82 services76 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

49 services49 patients

Hospital Affiliations CMS Care Compare

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

Javon Bea Hospital

Acute Care Hospitals · Rockford, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140239

Location8201 E Riverside BlvdRockford, IL 61114 · Winnebago County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 61103 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

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

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 20

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

KIMBERLY REMEDIOS-SMITH M.D.

Pediatrics (Neonatal-Perinatal Medicine)