MARK BOODRAM PT, DPT
NPI 1255159463
Physical Therapist - Orthopedic in New York, NY
About Mark Boodram Pt, Dpt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARK BOODRAM PT, DPT (NPI 1255159463) is an individual orthopedic provider in New York, New York and active in the NPI registry since September 2024. He is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mark Boodram Pt, Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mark Boodram reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
New York, NY 10017
- Reassigned Medicare billing, New York enrollment
- 24 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Other Providers at the Same Location NPPES 13
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
NEW YORK, NY 10011
NEW YORK, NY 10011
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mark Boodram's NPI number?
The NPI number for Mark Boodram is 1255159463. It was assigned to this individual provider in the NPPES registry on September 27, 2024.
Where is Mark Boodram located?
Mark Boodram practices at 138 5th Ave Fl 2, New York, NY 10011. The listed phone number is (646) 490-4002.
What is Mark Boodram's specialty?
The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.
Is Mark Boodram enrolled in Medicare?
Yes. Mark Boodram is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Mark Boodram's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mark Boodram reassigns Medicare benefits to Bespoke Treatments Physical Therapy PC (New York, NY). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Mark Boodram's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Mark Boodram was last updated on September 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Mark Boodram, PT, DPT · NPI 1255159463
Orthopedic provider in New York, New York. Individual provider, active in the CMS NPPES registry since September 27, 2024.
## Identity
- **NPI:** 1255159463 (Entity type: Individual)
- **Enumerated:** September 27, 2024
- **Primary specialty:** Physical Therapist - Orthopedic · taxonomy 2251X0800X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 138 5TH AVE FL 2, New York, NY 10011-4367
- **Phone:** (646) 490-4002
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Bills Medicare through:** Bespoke Treatments Physical Therapy PC (NPI 1336756758, New York, NY), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** September 27, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1255159463) · Data from the CMS NPPES public registry.