BROCK A BOEKHOUT (PHD) – Psychologist, NPI 1275502148

BROCK A BOEKHOUT (PHD) is a healthcare provider. based in Pittsburg, Kansas. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 1346 (KS). The NPI Number for BROCK A BOEKHOUT (PHD) is 1275502148

Main info

Male
26 Years Of Experience
Accepts Medicare Assignment
Name
BROCK A BOEKHOUT (PHD)
NPI
1275502148
Phone
(620) 231-9873
Address
PO BOX 1832
Enumeration Date
14 March 2006
Last Update Date
28 December 2022

Doctor Profile

Medical School Name
TEXAS TECH UNIVERSITY HEALTH SCIENCE CENTER SCHOOL OF MEDICINE
Secondary Phone
-
Graduation Year
2000 (26 years ago)
PAC ID
1456343680
Group Practice PAC ID
7911816392
Professional Enrollment ID
I20070316000380
Address ID
KS667622546PI3015XSTXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience64
Completeness75
Years active:20State licenses:1Digital endpointsOther names

282 CLINICAL PSYCHOLOGIST in KS

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Provider Addresses for BROCK A BOEKHOUT (PHD)

  • PO BOX 1832

    PITTSBURG, KS 667621832

    Phone: (620) 231-9873

    Fax: (620) 231-2808

    Type: Mailing

  • 3011, North Michigan Street, Pittsburg, Crawford County, Kansas, 66762, United States

    PITTSBURG, KS 667622546

    Phone: (620) 231-9873

    Fax: (620) 231-2808

    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: 2007-03-16

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
I20070316000380IClinical PsychologistKSTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 66762)

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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: 7911816392View full group profile
NameSpecialtyState
Nurse PractitionerKS
-KS
Pediatric Medicine, Internal Medicine, Pediatric MedicineOH
Nurse PractitionerKS
Nurse PractitionerKS
Physician AssistantKS
Nurse PractitionerKS
Nurse PractitionerKS
-KS
Nurse PractitionerKS

Reviews

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Frequently asked questions

What NPI should I save for BROCK A BOEKHOUT (PHD)?
Save NPI 1275502148 if you need a stable reference for BROCK A BOEKHOUT (PHD).
Is BROCK A BOEKHOUT (PHD)'s NPI currently valid?
The extract we use shows BROCK A BOEKHOUT (PHD) as active.
What kind of provider is BROCK A BOEKHOUT (PHD)?
The page reflects Psychologist for BROCK A BOEKHOUT (PHD). Clinical services aligned with this taxonomy classification.
Where does public data place BROCK A BOEKHOUT (PHD)?
The snapshot lists Pittsburg, Kansas for BROCK A BOEKHOUT (PHD); download NPPES for the complete set.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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