Plum Creek Pharmacy LLC
NPI 1366032302 · Community/Retail Pharmacy · Kyle, TX
Enrolled with Medicare as Part B Supplier - Mass Immunization (roster Biller Only) · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Plum Creek Pharmacy LLC is a Community/Retail Pharmacy organization in Kyle, TX (NPI 1366032302).
Provider details
- NPI number
- 1366032302
- Entity type
- Organization
- Primary specialty
- Community/Retail PharmacySuppliers
- Organization subpart
- No
- Authorized official
- Michael Boccieri, Manager(512) 289-0257
Specialties & taxonomies
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure28% of score
5 yrs in NPPES registry
- Profile completeness28% of score
100% of core fields populated
- Practice footprint17% of score
1 documented practice location
- Medicare service volume (vs. specialty peers)28% of score
139 Medicare services, 2024 (ranked within specialty)
Medicare volume is ranked against active providers in the same specialty. 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.
What this provider does (Medicare)
Based on Medicare fee-for-service claims, 2024; not all care is captured.
| Service (HCPCS) | Medicare services | Typical Medicare-allowed (2024) |
|---|---|---|
| Admn Sarscov2 Vacc 1 Dose90480 | 85 | $41 |
| Administration of Influenza Virus VaccineG0008 | 54 | $31 |
Typical Medicare-allowed amounts for these services range $31–$41 (2024). The Medicare-allowed amount is what Medicare recognizes for a service under fee-for-service — a reference figure for 2024, not a price quote and not what you would be billed. Medicare Part B covers roughly an eighth of all NPIs (65+ skew); services with fewer than 11 beneficiaries are suppressed by CMS. Source: CMS Medicare Physician & Other Practitioners, by Provider & Service.
Practice location
Mailing address
Other names (DBA / former)
- Doing business as
- Plum Creek Pharmacy
Registry dates
- Enumerated
- 2021-01-23
- Last updated
- 2021-01-23
- Certified
- 2021-01-23
Frequently asked questions
- What is Plum Creek Pharmacy LLC's NPI number?
- Plum Creek Pharmacy LLC's National Provider Identifier (NPI) is 1366032302, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Plum Creek Pharmacy LLC?
- Plum Creek Pharmacy LLC is classified in the NPPES registry as Community/Retail Pharmacy (Suppliers).
- Where is Plum Creek Pharmacy LLC located?
- Plum Creek Pharmacy LLC's practice location on file with NPPES is 4217 Benner Ste 430, Kyle, TX 78640-2555.
- What is Plum Creek Pharmacy LLC's phone number?
- The practice phone number listed in the NPPES registry for Plum Creek Pharmacy LLC is (512) 289-0257.
- Does Plum Creek Pharmacy LLC accept Medicare?
- Plum Creek Pharmacy LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Plum Creek Pharmacy LLC?
- The authorized official listed on Plum Creek Pharmacy LLC's NPPES record is Michael Boccieri, Manager. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Plum Creek Pharmacy LLC's NPI active?
- Yes — Plum Creek Pharmacy LLC's NPI (1366032302) is active in the NPPES registry as of the last update on 2021-01-23.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.