KELLIE BOISTON – Physical Therapist, NPI 1558458083

KELLIE BOISTON is a healthcare provider. based in Riverside, California. specializing in Physical Therapist. They hold a License No. PT 23197 (CA). The NPI Number for KELLIE BOISTON is 1558458083

Main info

Female
29 Years Of Experience
Accepts Medicare Assignment
Name
KELLIE BOISTON
NPI
1558458083
Phone
(951) 653-4480
Address
6177 RIVER CREST DR STE A
Enumeration Date
6 October 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9516534480
Graduation Year
1997 (29 years ago)
PAC ID
5698664282
Group Practice PAC ID
7214824648
Professional Enrollment ID
I20040311001524
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

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Provider Addresses for KELLIE BOISTON

  • 6177, River Crest Drive, Riverside, Riverside County, California, 92507, United States

    RIVERSIDE, CA 925070728

    Phone: (951) 653-4480

    Fax: (951) 653-5051

    Mailing address matches the actual address.

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.

No Medicare enrollment or revalidation data available for this provider in our database.

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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 92507)

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Provider's Procedures

KELLIE BOISTON performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYCA97001Physical therapy evaluation2522
PHYSICAL THERAPYCA97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes15018

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: 7214824648View full group profile
NameSpecialtyState
EDWIN DAVE RICKETTS (OTR/L)
Occupational Therapist In Private PracticeCA
KAREN E DIAZ (OTR/L)
Occupational Therapist In Private PracticeCA
LYNN KEIKO NISHIKAWA (S.P.L.)
Qualified Speech Language PathologistCA
JESSE GANDT
Physical Therapist In Private PracticeCA
MRS. MARCHAND MARIE MONTIEL (MPT)
Physical Therapist In Private PracticeCA
BEVERLY HAMMANT (PT)
-NM
KIMBERLY KING
Physical Therapist In Private PracticeCA
NICOLE PACKWOOD (PT, DPT)
Physical Therapist In Private PracticeCA
WEI-YUN LAI
-CA
SAYRA SAPIEN
Physical Therapist In Private PracticeCA

Reviews

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Frequently asked questions

Does KELLIE BOISTON share an NPI with anyone else?
NPI numbers are unique to each provider or organization — KELLIE BOISTON uses 1558458083.
Can I rely on KELLIE BOISTON being an active provider?
As of the registry snapshot, KELLIE BOISTON is marked active.
What taxonomy line describes KELLIE BOISTON?
For research purposes, treat KELLIE BOISTON as Physical Therapist in this dataset. Clinical services aligned with this taxonomy classification.
Where is KELLIE BOISTON based?
KELLIE BOISTON is tied to Riverside, California in the data we show; additional addresses may exist on the full record.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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