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

Individual provider Physician Assistant · NPI 1154095727

Brooklynn Ashley Boulware, PA-C is a Physician Assistant in Philadelphia, Pennsylvania. Qualified in 2022, 4 years ago. Practices with University of Penn-Medical Group, a 3,401-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
4
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

1840 S Street 2nd Fl
Philadelphia, PA 19146-7422
Phone: (215) 893-2240
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1154095727
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorYes
NPI enumeratedAugust 5, 2021
Last updated in NPPESJune 8, 2023
Certification dateApril 12, 2023

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice University Of Penn-Medical Group — 3401 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations8 on file with Medicare

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