Timothy Lewis Boomer, PA-C
NPI 1710230172ActiveIndividual· Physician Assistant, Medical· Lubbock, TX
Physician Assistant, Medical (PA-C) with Kidney Disease Associates and 1 other group, practicing in Lubbock, Texas. Part D covered 75 prescriptions written in 2024, 89% of them generic. Lists Covenant Medical Center and 1 other hospital as hospital affiliations.
Overview
| NPI | 1710230172 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Oct 23, 2012 |
| Last updated in NPPES | Feb 16, 2024 |
| Certified by provider | Feb 16, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | — | — |
| Physician Assistant, Surgical | 363AS0400X | — | TX |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (TX) |
|---|
Part D prescriptions in 2024
| Prescriptions (claims) | 75 · 83 30-day fills |
|---|---|
| Patients | 23 |
| Total drug cost | $12,358 |
| Generic share | 89% of claims |
Education and affiliations
| Graduation year | 2012 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical groups
- Kidney Disease AssociatesHobbs, NM · 2 clinicians
- James Todd Rose MD PALubbock, TX · 2 clinicians
Hospital affiliations
- Covenant Medical CenterLubbock, TX
- University Medical CenterLubbock, TX
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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