DR. KENNETH JEROME BOOMGAARD (M.D.) – Family Medicine Physician, NPI 1427047034

DR. KENNETH JEROME BOOMGAARD (M.D.) is a healthcare provider. based in Chugiak, Alaska. specializing in FAMILY PRACTICE. They hold the professional credentials M.D.. They hold a License No. 4301071073 (MI). The NPI Number for DR. KENNETH JEROME BOOMGAARD (M.D.) is 1427047034

Main info

Male
31 Years Of Experience
Accepts Medicare Assignment
Name
DR. KENNETH JEROME BOOMGAARD (M.D.)
NPI
1427047034
Phone
(907) 688-7826
Address
21950 SHELTERING SPRUCE LOOP
Enumeration Date
17 October 2005
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
9075632873
Graduation Year
1995 (31 years ago)
PAC ID
9436331840
Group Practice PAC ID
7911892443
Professional Enrollment ID
I20110307000506
Address ID
AK995085230AN4100XPKWY471
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

495 FAMILY PRACTICE in AK

Provider Addresses for DR. KENNETH JEROME BOOMGAARD (M.D.)

  • 21950 SHELTERING SPRUCE LOOP

    CHUGIAK, AK 995675402

    Phone: (907) 688-7826

    Fax: (907) 580-2308

    Type: Mailing

  • 3RD MEDICAL GROUP, ELMENDORF REGIONAL MEDICAL CENTER

    5955 ZEAMER AVE

    ELMENDORF AFB, AK 995063700

    Phone: (907) 580-2956

    Fax: (907) 580-2308

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 80 Open Payments records for all available years, with a total value of $1,650.

Total Amount is formed as General ($1,650) + Research ($0) + Ownership ($0) = $1,650.

Last reported payment date: 2024-11-15 • Largest payer in this snapshot: ABBVIE INC. ($462).

Total Amount

$1,650

General + Research + Ownership

Payments

80

Total payment records

General Amount

$1,650

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-11-15

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2011-03-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20110307000506IFamily PracticeAKTBD

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.

Verify on CMS Revalidation Lookup Tool

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99213Established patient office or other outpatient visit, 20-29 minutes1,193288$0
99214Established patient office or other outpatient visit, 30-39 minutes1,009284$0
80307Testing for presence of drug, by chemistry analyzers847272$0
J3301Injection, triamcinolone acetonide, not otherwise specified, 10 mg828102$0
20611Aspiration and/or injection of fluid large joint using ultrasound guidance9467$0
View full utilization report →

Insurance plans in this area (ZIP 99567)

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Provider's Procedures

DR. KENNETH JEROME BOOMGAARD (M.D.) performs procedures in FAMILY PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
FAMILY MEDICINEAK76942Ultrasonic guidance imaging supervision and interpretation for insertion of needle1811

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7911892443View full group profile
NameSpecialtyState
Nurse PractitionerAK
Anesthesiology, Pain ManagementAK
Physician AssistantCA
Anesthesiology, Pain ManagementPA
Physical Medicine And RehabilitationAK
-AK
-AK
-AK
Anesthesiology, Pain Management, Pain ManagementWA

Reviews

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Frequently asked questions

What unique ID ties claims to DR. KENNETH JEROME BOOMGAARD (M.D.)?
NPI 1427047034 is assigned to DR. KENNETH JEROME BOOMGAARD (M.D.) under the national enumeration system.
Is DR. KENNETH JEROME BOOMGAARD (M.D.) currently active in the NPI registry?
CMS-published data lists DR. KENNETH JEROME BOOMGAARD (M.D.) as an active registrant.
What kind of provider is DR. KENNETH JEROME BOOMGAARD (M.D.)?
The page reflects Family Medicine Physician for DR. KENNETH JEROME BOOMGAARD (M.D.). Clinical services aligned with this taxonomy classification.
Does DR. KENNETH JEROME BOOMGAARD (M.D.) practice in Alaska?
You will see Chugiak, Alaska on file for DR. KENNETH JEROME BOOMGAARD (M.D.) alongside any extra practice locations.
How can I contact DR. KENNETH JEROME BOOMGAARD (M.D.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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