JEFFERSON L BOULET (PAC) – Medical Physician Assistant, NPI 1740274745
Medical Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
4,282 PHYSICIAN ASSISTANT in WA
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Provider Addresses for JEFFERSON L BOULET (PAC)
305, North River Avenue, Buckley, Pierce County, Washington, 98321, United States
BUCKLEY, WA 983218978
Phone: (360) 829-0625
Fax: (360) 829-9860
Type: Location
PO BOX 1268
BUCKLEY, WA 983211268
Phone: (360) 829-0625
Fax: (360) 829-9860
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 24 Open Payments records for all available years, with a total value of $422.
Total Amount is formed as General ($422) + Research ($0) + Ownership ($0) = $422.
Last reported payment date: 2024-11-14 • Largest payer in this snapshot: ABBVIE INC. ($259).
Total Amount
$422
General + Research + Ownership
Payments
24
Total payment records
General Amount
$422
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-11-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| ABBVIE INC. | $259 |
| Astellas Pharma US Inc | $80 |
| Lilly USA, LLC | $31 |
| Lundbeck LLC | $24 |
| Boehringer Ingelheim Pharmaceuticals, Inc. | $15 |
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: 2010-03-25
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100325000615 | I | Physician Assistant | WA | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 320 | 122 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 248 | 118 | $0 |
| 36415 | Insertion of needle into vein for collection of blood sample | 86 | 72 | $0 |
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 84 | 28 | $0 |
| G0439 | Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit | 34 | 34 | $0 |
Insurance plans in this area (ZIP 98321)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice, General Practice | WA | |
| Physician Assistant | WA |
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