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MR. JUSTIN BOUTWELL PA
NPI 1861959017
Physician Assistant - Medical in Broken Bow, NE

Active since February 25, 2019PECOS Enrolled
145 MEMORIAL DR, BROKEN BOW, NE 68822(308) 872-2486(308) 872-2027 Get Directions Write a Review

NPPES record last updated: August 19, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Aug 19, 2019, Aug 9, 2019, Feb 25, 2019 (3 updates tracked since 2019).

About Mr. Justin Boutwell Pa NPPES

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

MR. JUSTIN BOUTWELL PA (NPI 1861959017) is an individual medical provider in Broken Bow, Nebraska, licensed in Nebraska (2387) and active in the NPI registry since February 2019. He is enrolled in Medicare PECOS and maintains a secondary practice location in Holdrege.

NPPES Registry Identity

NPI1861959017
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. JUSTIN BOUTWELLCredential: PA
Location Address145 MEMORIAL DRBroken Bow, NE 68822-1378
Mailing Address145 Memorial DrBroken Bow, NE 68822-1378 · (308) 991-4571 · Fax (308) 872-2027
Phone(308) 872-2486
Fax(308) 872-2027
Sole ProprietorNo
Enumeration DateFebruary 25, 2019
Last NPPES UpdateAugust 19, 20193 updates tracked since enumeration
✔ NPI 1861959017 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 NE · 2387
145 MEMORIAL DR, Broken Bow, NE 68822
Open in Google Maps ↗

Secondary Practice Location 1

Location 11316 Logan StHoldrege, NE 68949-1448 · Phone (308) 991-4571

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, 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 (PECOS)

Mr. Justin Boutwell Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Other Providers at the Same Location NPPES 14

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

JENNIE M MELHAM MEMORIAL MEDICAL CENTER
Nursing Facility/Intermediate Care Facility
145 MEMORIAL DR
BROKEN BOW, NE 68822
Custer County (308) 872-2625
JENNIE M MELHAM MEMORIAL MEDICAL CENTER
Hospice Care, Community Based
145 MEMORIAL DR
BROKEN BOW, NE 68822
Custer County (308) 872-2625
JENNIE M MELHAM MEMORIAL MEDICAL CENTER
Durable Medical Equipment & Medical Supplies
145 MEMORIAL DR
BROKEN BOW, NE 68822
Custer County (308) 872-2625
JENNIE M MELHAM MEMORIAL MEDICAL CENTER
Home Health
145 MEMORIAL DR
BROKEN BOW, NE 68822
Custer County (308) 872-2625
DR. ROBERT R KAHNK MD
Family Medicine
145 MEMORIAL DR
BROKEN BOW, NE 68822
Custer County (308) 872-2486
JENNIE M MELHAM MEMORIAL MEDICAL CENTER INC
Nurse Anesthetist, Certified Registered
145 MEMORIAL DR
BROKEN BOW, NE 68822
Custer County (308) 872-4100
VALERIE HARRIS LCSW
Counselor (Mental Health)
145 MEMORIAL DR
BROKEN BOW, NE 68822
Custer County (308) 872-4020
JULIE A LINDSTROM D.O.
Family Medicine
145 MEMORIAL DR
BROKEN BOW, NE 68822
Custer County (308) 872-2486

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 Justin Boutwell's NPI number?

The NPI number for Justin Boutwell is 1861959017. It was assigned to this individual provider in the NPPES registry on February 25, 2019.

Where is Justin Boutwell located?

Justin Boutwell practices at 145 Memorial Dr, Broken Bow, NE 68822. The listed phone number is (308) 872-2486.

What is Justin Boutwell's specialty?

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

Is Justin Boutwell enrolled in Medicare?

Yes. Justin Boutwell is registered in the Medicare PECOS enrollment system.

What insurance does Justin Boutwell accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Blue Cross and Blue Shield of Nebraska and 3 other insurers list Justin Boutwell 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.

When was this NPI record last updated?

The NPPES record for Justin Boutwell was last updated on August 19, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.