DR. MICHAEL BOOTH (MD) – Family Medicine Physician, NPI 1184073629

DR. MICHAEL BOOTH (MD) is a healthcare provider. based in Madisonville, Kentucky. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. S3124 (TX). The NPI Number for DR. MICHAEL BOOTH (MD) is 1184073629

Main info

Male
Sole Proprietor
10 Years Of Experience
Accepts Medicare Assignment
Name
DR. MICHAEL BOOTH (MD)
NPI
1184073629
Phone
(270) 825-6680
Address
200 CLINIC DR
Enumeration Date
6 June 2016
Last Update Date
10 April 2024

Doctor Profile

Medical School Name
UNIVERSITY OF TEXAS MEDICAL SCHOOL AT HOUSTON
Secondary Phone
9722645858
Graduation Year
2016 (10 years ago)
PAC ID
6103199005
Group Practice PAC ID
7810237740
Professional Enrollment ID
I20230509003113
Address ID
TX750527280GR2520XIXXX301
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience49
Completeness75
Years active:10State licenses:1Digital endpointsOther names

1,718 FAMILY PRACTICE in KY

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Provider Addresses for DR. MICHAEL BOOTH (MD)

  • 200, Clinic Drive, Madisonville, Hopkins County, Kentucky, 42431, United States

    MADISONVILLE, KY 424311661

    Phone: (270) 825-6680

    Fax: (270) 825-7266

    Type: Location

  • 2520 W I 20

    GRAND PRAIRIE, TX 750527280

    Phone: (972) 264-5858

    Fax: (972) 264-8800

    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: 2023-05-09

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
I20230509003113IFamily PracticeTXTBD

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 42431)

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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: 7810237740View full group profile
NameSpecialtyState
-TX
Nurse PractitionerTX
Family PracticeLA
Physician AssistantTX
Family PracticeTX
Nurse PractitionerTX
Physician AssistantMA
-TX
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Can I verify DR. MICHAEL BOOTH (MD) with an NPI only?
You can start verification with NPI 1184073629 for DR. MICHAEL BOOTH (MD), then check state licensing separately.
Does the file indicate DR. MICHAEL BOOTH (MD) is practicing under active NPI?
Directory data currently reports DR. MICHAEL BOOTH (MD) as active.
What is DR. MICHAEL BOOTH (MD)'s primary classification?
Family Medicine Physician is the headline specialty for DR. MICHAEL BOOTH (MD) here. Clinical services aligned with this taxonomy classification.
What area does DR. MICHAEL BOOTH (MD) serve?
DR. MICHAEL BOOTH (MD)'s listing highlights Madisonville, Kentucky; more addresses can appear in NPPES.
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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