DR. DANIEL THEODORE BOEDER
NPI 1669039822
Psychiatry & Neurology - Child & Adolescent Psychiatry in Springfield, IL

Q: What is Daniel Boeder's NPI number?

The NPI number for Daniel Boeder is 1669039822. It was assigned to this individual provider in the NPPES registry on May 23, 2019.

Q: What is Daniel Boeder's specialty?

The primary specialty registered for this NPI is Psychiatry & Neurology, specializing in Child & Adolescent Psychiatry, with taxonomy code 2084P0804X.

Q: When was this NPI record last updated?

The NPPES record for Daniel Boeder was last updated on June 25, 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.

Active since May 23, 2019PECOS Enrolled

319 E MADISON ST FL 3, SPRINGFIELD, IL 62701(217) 545-6900(217) 585-6893 Get Directions Write a Review

NPPES record last updated: June 25, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 25, 2024, Jul 12, 2021, May 23, 2019 (3 updates tracked since 2019).

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About Dr. Daniel Theodore Boeder NPPES

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

DR. DANIEL THEODORE BOEDER (NPI 1669039822) is an individual child & adolescent psychiatry provider in Springfield, Illinois, licensed in Illinois (125.073980) and active in the NPI registry since May 2019. He is enrolled in Medicare PECOS and is a graduate of Southern Illinois University School Of Medicine (2019).

NPPES Registry Identity

NPI1669039822

Entity TypeIndividualMale

Primary Taxonomy2084P0804X

Provider Legal NameDR. DANIEL THEODORE BOEDER

Location Address319 E MADISON ST FL 3Springfield, IL 62701-1035

Mailing AddressPo Box 19642Springfield, IL 62794-9642 · (217) 656-8229 · Fax (217) 585-6893

Phone(217) 545-6900

Fax(217) 585-6893

Sole ProprietorNo

Medical School CMSSouthern Illinois University School Of MedicineGraduated 2019

Enumeration DateMay 23, 2019

Last NPPES UpdateJune 25, 20243 updates tracked since enumeration

NPPES CertifiedJune 25, 2024

✔ NPI 1669039822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPsychiatry & Neurology · Child & Adolescent PsychiatryAllopathic & Osteopathic Physicians

Taxonomy Code2084P0804X

License✔ Licensed in IL · 125.073980

Definition

Child & Adolescent Psychiatry is a subspecialty of psychiatry with additional skills and training in the diagnosis and treatment of developmental, behavioral, emotional, and mental disorders of childhood and adolescence.

Also ListedPsychiatry & Neurology · PsychiatryTaxonomy 2084P0800X · License 125.073980 (IL)

319 E MADISON ST FL 3, Springfield, IL 62701

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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Oscar Insurance Company.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Daniel Theodore Boeder is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID547596058

PECOS Enrollment IDI20250923003854

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.

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.

MADELEINE ELIZABETH BRINDLE MD

Internal Medicine