Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Bernard Theodore Botiller, PA-C

Individual provider Physician Assistant · NPI 1588674865

Bernard Theodore Botiller, PA-C is a Physician Assistant in Lexington, Kentucky. Qualified in 2001, 25 years ago. Practices with Central Kentucky Kidney Care LLC, a 4-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Kentucky.

Years since qualifying
25
Licensed in
KY
In the registry since
2006
Specialties on file
2
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Incomplete address

The federal record is missing the street or ZIP for this provider.

1451 Harrodsburg Rd Ste D 304
Lexington, KY 40504
Phone: (859) 977-4000
Fax: (859) 977-5100

No coordinates on file. Search this address in Google Maps

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA674 (KY)
Medical Physician Assistant Taxonomy 363AM0700X · Licence PA674 (KY)

Record details

NPI number1588674865
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 9, 2006
Last updated in NPPESMay 24, 2016

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Central Kentucky Kidney Care Llc — 4 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations3 on file with Medicare

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