KIMBERLEY JEAN BOOSALES (C-AA) – Anesthesiologist Assistant, NPI 1205257136

KIMBERLEY JEAN BOOSALES (C-AA) is a healthcare provider. based in Palm harbor, Florida. specializing in ANESTHESIOLOGY ASSISTANT. They hold the professional credentials C-AA. They hold a License No. AA211 (FL). The NPI Number for KIMBERLEY JEAN BOOSALES (C-AA) is 1205257136

Main info

Female
13 Years Of Experience
Accepts Medicare Assignment
Name
KIMBERLEY JEAN BOOSALES (C-AA)
NPI
1205257136
Phone
(678) 699-7696
Address
4322 ENFIELD CT
Enumeration Date
19 December 2013
Last Update Date
22 February 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
2013 (13 years ago)
PAC ID
7315179793
Group Practice PAC ID
6406753623
Professional Enrollment ID
I20140417001160
Address ID
FL336076307TA3003XBLVD800
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:12State licenses:1Digital endpointsOther names

936 ANESTHESIOLOGY ASSISTANT in FL

Provider Addresses for KIMBERLEY JEAN BOOSALES (C-AA)

  • 4322 ENFIELD CT

    PALM HARBOR, FL 346851051

    Phone: (678) 699-7696

    Type: Mailing

  • 1600 SW Archer Rd

    Gainesville, FL 326103003

    Phone: (352) 273-8610

    Type: Location

  • 3231 MCMULLEN BOOTH RD

    SAFETY HARBOR, FL 34695

    Phone: (727) 725-6111

    Type: Location

  • PO BOX 100254

    GAINESVILLE, FL 326100254

    Phone: (352) 273-8610

    Type: Mailing

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: 2014-04-17

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
I20140417001160IAnesthesiology AssistantFLTBD

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
00731Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope1111$0
View full utilization report →

Insurance plans in this area (ZIP 34685)

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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: 6406753623View full group profile

Reviews

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Frequently asked questions

How is KIMBERLEY JEAN BOOSALES (C-AA) identified in CMS data?
CMS-hosted NPPES data lists KIMBERLEY JEAN BOOSALES (C-AA) with NPI 1205257136.
Is KIMBERLEY JEAN BOOSALES (C-AA) still practicing?
KIMBERLEY JEAN BOOSALES (C-AA) is currently listed as active in the public NPI registry.
What healthcare role does KIMBERLEY JEAN BOOSALES (C-AA) hold?
Scheduling teams often label KIMBERLEY JEAN BOOSALES (C-AA) under Anesthesiologist Assistant. Clinical services aligned with this taxonomy classification.
Where is KIMBERLEY JEAN BOOSALES (C-AA) based?
KIMBERLEY JEAN BOOSALES (C-AA) is tied to Palm Harbor, Florida in the data we show; additional addresses may exist on the full record.
Is the information about KIMBERLEY JEAN BOOSALES (C-AA) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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