SAMUEL BODERMAN
NPI 1619506334
Internal Medicine in Madison, WI

Q: What is Samuel Boderman's NPI number?

The NPI number for Samuel Boderman is 1619506334. It was assigned to this individual provider in the NPPES registry on April 4, 2020.

Q: What is Samuel Boderman's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Samuel Boderman was last updated on November 16, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since April 04, 2020PECOS Enrolled

UW HOSPITALS & CLINICS 600 HIGHLAND AVE, MADISON, WI 53792(608) 263-6400 Get Directions Write a Review

NPPES record last updated: November 16, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Nov 16, 2022, Apr 4, 2020 (2 updates tracked since 2020).

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About Samuel Boderman NPPES

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

SAMUEL BODERMAN (NPI 1619506334) is an individual internal medicine provider in Madison, Wisconsin, licensed in Wisconsin (77526-20) and active in the NPI registry since April 2020. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1619506334

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameSAMUEL BODERMAN

Location AddressUW HOSPITALS & CLINICS 600 HIGHLAND AVEMadison, WI 53792-0001

Mailing AddressUw Hospitals & Clinics 600 Highland AveMadison, WI 53792-0001

Phone(608) 263-6400

Sole ProprietorNo

Enumeration DateApril 4, 2020

Last NPPES UpdateNovember 16, 20222 updates tracked since enumeration

NPPES CertifiedNovember 16, 2022

✔ NPI 1619506334 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in WI · 77526-20

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

UW HOSPITALS & CLINICS 600 HIGHLAND AVE, Madison, WI 53792

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samuel Boderman is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 53792 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$123.69 typical visit price

range $53.90 – $163.24

Typical copayment $30.92 (range $13.47 – $40.81)

Most-billed visit code 99204

Established Patient

$95.41 typical visit price

range $17.40 – $133.76

Typical copayment $23.85 (range $4.35 – $33.44)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

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