KENNETH BOOCKVAR (MD) – Geriatric Medicine (Internal Medicine) Physician, NPI 1497723845
Geriatric Medicine (Internal Medicine) Physician
Main info
Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
53 GERIATRIC MEDICINE in AL
Provider Addresses for KENNETH BOOCKVAR (MD)
PO BOX 55310
BIRMINGHAM, AL 352555310
Phone: (205) 731-9701
Fax: (205) 297-9411
Type: Mailing
619 19TH ST S
BIRMINGHAM, AL 352496508
Phone: (205) 731-9701
Type: Location
500 22nd St S
Birmingham, AL 352333110
Phone: (205) 933-2232
Type: Location
New York, United States
ONE GUSTAVE L LEVY PLACE
NEW YORK, NY 10029
Phone: (212) 241-5561
Fax: (212) 860-9737
Type: Mailing
1440, Madison Avenue, East Harlem, Manhattan Community Board 11, Manhattan, New York County, New York, 10029, United States
NEW YORK, NY 100296508
Phone: (212) 659-8552
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-11-07
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20051116000923 | I | Internal Medicine | NY | TBD |
| I20221107002103 | I | Geriatric Medicine | AL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 35255)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| N E P H R O L O G Y | TX | |
| - | AL | |
| A N E S T H E S I O L O G Y | AL | |
| E N D O C R I N O L O G Y | VA | |
| Nurse Practitioner | AL | |
| - | AL | |
| Hospitalist, Internal Medicine | AL | |
| Clinical Psychologist | AL | |
| Nurse Practitioner | AL | |
| - | AL |
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