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MR. DAVID ALDEN BOEDEKER PA-C
NPI 1508311085
Physician Assistant - Medical in Lansing, MI

Active since August 24, 2016PECOS EnrolledAccepts Medicare Assignment
2815 S. PENNSYLVANIA AVE, SUITE 204, LANSING, MI 48910(517) 267-0200(517) 267-1877 Get Directions Write a Review

NPPES record last updated: October 4, 2021. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 4, 2021, Aug 29, 2016, Aug 24, 2016 (3 updates tracked since 2016).

About Mr. David Alden Boedeker Pa-c NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. DAVID ALDEN BOEDEKER PA-C (NPI 1508311085) is an individual medical provider in Lansing, Michigan, licensed in Wyoming (PT696) and active in the NPI registry since August 2016. He is enrolled in Medicare PECOS, is affiliated with Monument Health Spearfish Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1508311085
Entity TypeIndividualMale
Primary Taxonomy363AM0700X
Provider Legal NameMR. DAVID ALDEN BOEDEKERCredential: PA-C
Location Address2815 S. PENNSYLVANIA AVE, SUITE 204Lansing, MI 48910-3496
Mailing Address2815 S. Pennsylvania Ave, Suite 204Lansing, MI 48910-3496 · (517) 267-0200 · Fax (517) 267-1877
Phone(517) 267-0200
Fax(517) 267-1877
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateAugust 24, 2016
Last NPPES UpdateOctober 4, 20213 updates tracked since enumeration
NPPES CertifiedOctober 4, 2021
✔ NPI 1508311085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
Licenses✔ Licensed in WY · PT696✔ Licensed in MI · 5601008520
2815 S. PENNSYLVANIA AVE, Lansing, MI 48910
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Avera Health Plans, Blue Cross Blue Shield of Wyoming, Medica and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. David Alden Boedeker Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID1557658960
PECOS Enrollment IDI20160929000599, I20250421002627
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Monument Health Spearfish Hospital

Acute Care Hospitals · Spearfish, SD
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number430048
Location1440 N Main StSpearfish, SD 57783 · Lawrence County
Emergency services

Monument Health Rapid City Hospital

Acute Care Hospitals · Rapid City, SD
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number430077
Location353 Fairmont BlvdRapid City, SD 57701 · Pennington County
Emergency services Birthing friendly

Black Hills Surgical Hospital LLP

Acute Care Hospitals · Rapid City, SD
OwnershipProprietary
CMS Certification Number430091
Location216 Anamaria DrRapid City, SD 57703 · Pennington County

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 David Boedeker's NPI number?

The NPI number for David Boedeker is 1508311085. It was assigned to this individual provider in the NPPES registry on August 24, 2016.

Where is David Boedeker located?

David Boedeker practices at 2815 S. Pennsylvania Ave Suite 204, Lansing, MI 48910. The listed phone number is (517) 267-0200.

What is David Boedeker's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is David Boedeker enrolled in Medicare?

Yes. David Boedeker is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does David Boedeker accept?

Health plans from Avera Health Plans, Blue Cross Blue Shield of Wyoming, Medica and Sanford Health Plan list David Boedeker as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is David Boedeker affiliated with any hospitals?

According to CMS data, David Boedeker is affiliated with Monument Health Spearfish Hospital, Monument Health Rapid City Hospital and Black Hills Surgical Hospital LLP.

When was this NPI record last updated?

The NPPES record for David Boedeker was last updated on October 4, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.