Michael S Boedefeld (NPI# 1043299548, PAC ID# 2567403066) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is INTERVENTIONAL PAIN MANAGEMENT.
Nation Provider ID (NPI) | 1043299548 |
PAC ID by PECOS | 2567403066 |
Professional Enrollment ID | I20050516000089 |
Full Name | Michael S Boedefeld |
Organization Legal Name | PRO PAIN LLC |
Address |
4800 Mexico Rd Suite 101 Saint Peters MO 63376-1666 |
Phone Number | 6364425035 |
Gender | M |
Credential | MD |
Medical School | CREIGHTON UNIVERSITY SCHOOL OF MEDICINE |
Graduation Year | 1999 |
Primary Specialty | INTERVENTIONAL PAIN MANAGEMENT |
Secondary Specialties | ANESTHESIOLOGY |
Group Practice PAC ID | 0941563225 |
Number of Group Practice Members | 2 |
Accepts Medicare Assignment | Y |
Claim Control Number (CCN) | Legal Business Name |
---|---|
260081 | SSM ST CLARE HEALTH CENTER |
260005 | SSM ST JOSEPH HEALTH CENTER |
260191 | BARNES-JEWISH ST PETERS HOSPITAL |
260200 | SSM ST JOSEPH HOSPITAL WEST |
260179 | ST LUKES HOSPITAL |
Address | Phone | Organization |
---|---|---|
100 Medical Plz, Suite 107, Lake St Louis, MO 63367-1366 | 6366255342 | SSM MEDICAL GROUP INC |
3555 Sunset Office Dr, Suite C100, Saint Louis, MO 63127-1014 | 3142389100 | SSM MEDICAL GROUP INC |
4800 Mexico Rd, Suite 101, Saint Peters, MO 63376-1666 | 6364425035 | PRO PAIN LLC |
1601 Wentzville Pkwy, Suite 117, Wentzville, MO 63385-3814 | 6363328455 | SSM MEDICAL GROUP INC |
Measure Identifier | Measure Title | Performance Rate | Reporting Mechanism |
---|---|---|---|
MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
MIPS_EC_130_overall | Documentation of Current Medications in the Medical Record | 100% | |
MIPS_EC_131_overall | Pain Assessment and Follow-Up | 100% | |
MIPS_EC_131_overall | Pain Assessment and Follow-Up | 100% | |
MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 100% | |
MIPS_EC_145_overall | Radiology: Exposure Dose or Time Reported for Procedures Using Fluoroscopy | 100% |
Organization Legal Name | PRO PAIN LLC |
Physicians | 2 |
Name | Specialty | Organization | Address |
---|---|---|---|
Chad C Shelton | Interventional Pain Management | Pro Pain LLC | 1055 Bowles Ave, Suite 202, Fenton, MO 63026-2308 |
Street Address |
4800 MEXICO RD SUITE 101 |
City | SAINT PETERS |
State | MO |
Zip | 63376-1666 |
Name | Specialty | Organization | Address |
---|---|---|---|
Rachel A Sappington | Nurse Practitioner | American Multispecialty Group Inc | 4800 Mexico Rd, Suite 102, Saint Peters, MO 63376-1666 |
Nicholas M Weber | Physical Therapy | Babar Enterprises LLC | 4800 Mexico Rd, Suite 104, Saint Peters, MO 63376-1666 |
Victoria M Weber | Physical Therapy | Babar Enterprises LLC | 4800 Mexico Rd, Suite 104, Saint Peters, MO 63376-1666 |
Lisa M Patt | Chiropractic | 4800 Mexico Rd, Suite 101, Saint Peters, MO 63376-1666 | |
Teresa Lozano | Physical Therapy | Babar Enterprises LLC | 4800 Mexico Rd, Suite 104, Saint Peters, MO 63376-1666 |
Joseph Michael Schmersahl | Physical Therapy | Babar Enterprises LLC | 4800 Mexico Rd, Suite 104, Saint Peters, MO 63376-1666 |
Christopher A Johnston | Physical Therapy | Babar Enterprises LLC | 4800 Mexico Rd, Suite 104, Saint Peters, MO 63376-1666 |
Charles Mcdonnell | Physical Therapy | Babar Enterprises LLC | 4800 Mexico Rd, Suite 104, Saint Peters, MO 63376-1666 |
Jessica Fuchs | Physical Therapy | Babar Enterprises LLC | 4800 Mexico Rd, Suite 104, Saint Peters, MO 63376-1666 |
Gerard Catapang | Physical Therapy | Babar Enterprises LLC | 4800 Mexico Rd, Suite 104, Saint Peters, MO 63376-1666 |
Find all physicians in the same address |
Name | Specialty | Organization | Address |
---|---|---|---|
Mary K Knight Macheca | Nurse Practitioner | Physician Groups Lc | 201 Bjc St Peters Dr, Suite 200, St Peters, MO 63376 |
Stanley Mathew | Endocrinology | Physician Groups Lc | 201 Bjc St Peters Dr, Suite 200, St Peters, MO 63376 |
Mei Chris Huang | Gastroenterology | Physician Groups Lc | 201 Bjc St Peters Dr, Suite 200, St Peters, MO 63376 |
Ranjani P Ramanathan | Endocrinology | Physician Groups Lc | 201 Bjc St Peters Dr, Suite 200, St Peters, MO 63376 |
Brittany Nicole Lyons | Nurse Practitioner | Physician Groups Lc | 201 Bjc St Peters Dr, Suite 200, St Peters, MO 63376 |
Prajakta Mungikar | Internal Medicine | Physician Groups Lc | 201 Bjc St Peters Dr, Suite 200, St Peters, MO 63376 |
Dianna J Ohlman | Nurse Practitioner | Physician Groups Lc | 201 Bjc St Peters Dr, Suite 200, St Peters, MO 63376 |
Gary J Meltz | Internal Medicine | Boonslick Medical Group Inc | 201 Bjc St Peters Dr, Suite 100, Saint Peters, MO 63376 |
Robert B Cusworth | Gastroenterology | Boonslick Medical Group Inc | 201 Bjc St Peters Dr, Saint Peters, MO 63376 |
Penny L Richardson | Chiropractic | 8471 Mexico Rd, Saint Peters, MO 63376-1103 | |
Find all physicians in zip 63376 |
City | SAINT PETERS |
Zip Code | 63376 |
Specialty | INTERVENTIONAL PAIN MANAGEMENT |
City + Specialty | SAINT PETERS + INTERVENTIONAL PAIN MANAGEMENT |
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Data Provider | Centers for Medicare & Medicaid Services (CMS) |
Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.