Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Kimberly Bousema, PA

Individual provider Physician Assistant · NPI 1629819826

Kimberly Bousema, PA is a Physician Assistant in Rensselaer, Indiana. Qualified in 2024, 2 years ago. Practices with Franciscan Physician Network, a 1,171-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
2
Licensed in
IN
In the registry since
2024
Specialties on file
2
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

See every abbreviation used in this directory →

Practice location Address checks out

1103 E Grace St
Rensselaer, IN 47978-3251
Phone: (219) 866-0411
Fax: (219) 866-1920
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 309 E 2nd St, Pomona, CA 91766-1854 — (909) 306-8660

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10004742A (IN)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1629819826
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA
Sole proprietorYes
NPI enumeratedJune 3, 2024
Last updated in NPPESMarch 7, 2025
Certification dateMarch 7, 2025

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Franciscan Physician Network — 1171 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations7 on file with Medicare