ANGELA BOOSE (APRN-PMHNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1194329458

ANGELA BOOSE (APRN-PMHNP) is a healthcare provider. based in Detroit, Michigan. specializing in NURSE PRACTITIONER. They hold the professional credentials APRN-PMHNP. They hold a License No. 28231278A (IN). The NPI Number for ANGELA BOOSE (APRN-PMHNP) is 1194329458

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
ANGELA BOOSE (APRN-PMHNP)
NPI
1194329458
Phone
(317) 528-4800
Address
PO BOX 781076
Enumeration Date
27 November 2020
Last Update Date
13 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2198642059
Graduation Year
2024 (2 years ago)
PAC ID
9931635836
Group Practice PAC ID
3072790682
Professional Enrollment ID
I20241214000194
Address ID
IN463111705DY24XXXSTXX300
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience43
Completeness75
Years active:5State licenses:2Digital endpointsOther names

8,191 NURSE PRACTITIONER in IN

Provider Addresses for ANGELA BOOSE (APRN-PMHNP)

  • PO BOX 781076

    DETROIT, MI 482781076

    Phone: (317) 528-4800

    Fax: (317) 865-1479

    Type: Mailing

  • 24 JOLIET ST

    DYER, IN 463111705

    Phone: (219) 322-5747

    Fax: (219) 864-2282

    Type: Location

  • 2600 Highway Ave

    Highland, IN 463221613

    Phone: (219) 972-0131

    Type: Location

  • 2600 HIGHWAY AVE

    HIGHLAND, IN 463221613

    Phone: (219) 972-0131

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 6 Open Payments records for all available years, with a total value of $344.

Total Amount is formed as General ($344) + Research ($0) + Ownership ($0) = $344.

Last reported payment date: 2024-12-12 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($146).

Total Amount

$344

General + Research + Ownership

Payments

6

Total payment records

General Amount

$344

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-12

Latest reported date

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: 2024-12-14

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
I20241214000194INurse PractitionerINTBD

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 48278)

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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: 3072790682View full group profile

Reviews

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Frequently asked questions

What is ANGELA BOOSE (APRN-PMHNP)'s NPI number?
ANGELA BOOSE (APRN-PMHNP)'s NPI is 1194329458 — the number used across U.S. healthcare to identify this provider.
Is ANGELA BOOSE (APRN-PMHNP) still an active registrant?
ANGELA BOOSE (APRN-PMHNP) carries an active NPI according to the public dataset.
What area of care is associated with ANGELA BOOSE (APRN-PMHNP)?
ANGELA BOOSE (APRN-PMHNP)'s record emphasizes Psychiatric/Mental Health Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Is ANGELA BOOSE (APRN-PMHNP) associated with Detroit?
Public fields place ANGELA BOOSE (APRN-PMHNP) around Detroit, Michigan. Always confirm the exact site before visiting.
When was this NPI issued?
Enumeration for ANGELA BOOSE (APRN-PMHNP) is noted as November 27, 2020 where the registry provides it.

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