Mark Boomershine, PA
NPI 1164617122 · Medical Physician Assistant · East Lansing, MI
Mark Boomershine, PA is a Medical Physician Assistant provider in East Lansing, MI (NPI 1164617122).
Provider details
- NPI number
- 1164617122
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Male
- Sole proprietor
- No
- License
- 5601001393 (MI)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2007-09-12
- Last updated
- 2023-03-07
Frequently asked questions
- What is Mark Boomershine's NPI number?
- Mark Boomershine's National Provider Identifier (NPI) is 1164617122, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Mark Boomershine's specialty?
- Mark Boomershine is listed in the NPPES registry with a primary specialty of Medical Physician Assistant (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Mark Boomershine located?
- Mark Boomershine's practice location on file with NPPES is 3496 E Lake Lansing Rd, East Lansing, MI 48823-2288.
- What is Mark Boomershine's phone number?
- The practice phone number listed in the NPPES registry for Mark Boomershine is (517) 333-0968.
- Is Mark Boomershine's NPI active?
- Yes — Mark Boomershine's NPI (1164617122) is active in the NPPES registry as of the last update on 2023-03-07.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.