MARK BOODRAM PT, DPT
NPI 1255159463
Physical Therapist - Orthopedic in New York, NY

Q: 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.

Q: What is Mark Boodram's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Orthopedic, with taxonomy code 2251X0800X.

Q: 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 22 months 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.

Active since September 27, 2024

138 5TH AVE FL 2, NEW YORK, NY 10011(646) 490-4002 Get Directions Write a Review

NPPES record last updated: September 27, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

On this page

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

NPI1255159463

Entity TypeIndividualMale

Primary Taxonomy2251X0800X

Provider Legal NameMARK BOODRAMCredential: PT, DPT

Location Address138 5TH AVE FL 2New York, NY 10011-4367

Mailing Address138 5th Ave Fl 2New York, NY 10011-4367 · (646) 490-4002

Phone(646) 490-4002

Sole ProprietorYes

Medical School CMSOtherGraduated 2024

Enumeration DateSeptember 27, 2024

NPPES CertifiedSeptember 27, 2024

✔ NPI 1255159463 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysical Therapist · OrthopedicRespiratory, Developmental, Rehabilitative and Restorative Service Providers

Taxonomy Code2251X0800X

Definition

A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Orthopaedic Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science; pathology/pathophysiology, pain science, medical and surgical considerations, orthopaedic physical therapy theory and practice, and critical inquiry for evidence-based practice.

138 5TH AVE FL 2, New York, NY 10011

Open in Google Maps ↗

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark Boodram Pt, Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6800367269

PECOS Enrollment IDI20260605002694

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.

REBECCA FELDBAUM PT, DPT

Physical Therapist