MR. KEVIN J BOLLAND (PA-C) – Physician Assistant, NPI 1962543033
Physician Assistant
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for MR. KEVIN J BOLLAND (PA-C)
19414 126TH ST E
BONNEY LAKE, WA 983916063
Phone: (253) 740-3245
Fax: (253) 826-4972
Type: Mailing
10828 GRAVELLY LAKE DR SW
LAKEWOOD, WA 984991334
Phone: (360) 436-6594
Type: Location
3920, West Tapps Drive East, Bonney Lake, Pierce County, Washington, 98391, United States
LAKE TAPPS, WA 983919176
Phone: (253) 862-8001
Fax: (253) 826-4972
Type: Mailing
9720, South Tacoma Way, Lakewood, Pierce County, Washington, 98499, United States
LAKEWOOD, WA 984994456
Phone: (253) 304-7753
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $20.
Total Amount is formed as General ($20) + Research ($0) + Ownership ($0) = $20.
Last reported payment date: 2023-07-14 • Largest payer in this snapshot: Neurocrine BioSciences, Inc. ($20).
Total Amount
$20
General + Research + Ownership
Payments
1
Total payment records
General Amount
$20
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-07-14
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Neurocrine BioSciences, Inc. | $20 |
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: 2008-07-01
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 |
|---|---|---|---|---|
| I20080701000201 | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 98391)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | WA | |
| Nurse Practitioner | WA | |
| - | WA | |
| Family Practice | WA | |
| - | WA | |
| - | WA | |
| Internal Medicine | WA | |
| Nurse Practitioner | WA |
Reviews
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