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

Mrs. Anita Boulom, PA-C

Individual provider Physician Assistant · NPI 1184213555

Mrs. Anita Boulom, PA-C is a Physician Assistant in Janesville, Wisconsin. Graduated from University of North Texas Hsc, College of Osteopathic Med in 2020, 6 years ago. Practices with Mercy Health System Corporation, a 751-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
6
Trained at
University of North Texas Hsc, College of Osteopathic Med
Licensed in
WI
In the registry since
2021
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

See every abbreviation used in this directory →

Practice location Address checks out

3400 Deerfield Dr
Janesville, WI 53546-3557
Phone: (608) 314-3600
Show map & directions

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

Additional practice locations (1)

  • 1000 Mineral Point Ave, Janesville, WI 53548-2940 — (608) 756-6000

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 5192-23 (WI)

Record details

NPI number1184213555
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 11, 2021
Last updated in NPPESJanuary 11, 2021
Certification dateJanuary 11, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolUNIVERSITY OF NORTH TEXAS HSC, COLLEGE OF OSTEOPATHIC MED
Graduated 2020 (6 years in practice)
Group practice Mercy Health System Corporation — 751 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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