MARY ELIZABETH BOEDEKER DPT
NPI 1780077123
Physical Therapist in Belleville, IL
About Mary Elizabeth Boedeker Dpt NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MARY ELIZABETH BOEDEKER DPT (NPI 1780077123) is an individual physical therapist in Belleville, Illinois, licensed in Illinois (070.021261) and active in the NPI registry since March 2015.
NPPES Registry Identity
Specialties & Licenses
- Diagnose and manage movement dysfunction and enhance physical and functional abilities.
- Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
- Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
- Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
- Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mary Elizabeth Boedeker Dpt is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Mary Boedeker reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Saint Louis, MO 63108
- Reassigned Medicare billing, Missouri enrollment
- 3 clinicians in this Medicare group
Ballwin, MO 63011
- Reassigned Medicare billing, Missouri enrollment
- 23 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.
Areas of Expertise CMS Part B claims 5
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Medicare Quality Performance CMS QPP · MIPS
Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.
Reported Quality Measures
Other Providers at the Same Location NPPES 5
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
BELLEVILLE, IL 62221
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 Mary Boedeker's NPI number?
The NPI number for Mary Boedeker is 1780077123. It was assigned to this individual provider in the NPPES registry on March 10, 2015.
Where is Mary Boedeker located?
Mary Boedeker practices at 144 Lincoln Place Ct, Belleville, IL 62221. The listed phone number is (618) 233-5163.
What is Mary Boedeker's specialty?
The primary specialty registered for this NPI is Physical Therapist with taxonomy code 225100000X.
Is Mary Boedeker enrolled in Medicare?
Yes. Mary Boedeker is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Mary Boedeker's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mary Boedeker reassigns Medicare benefits to 2 organizations: P2 Enterprises, LLC (Saint Louis, MO) and Apex Physical Therapy, LLC (Ballwin, MO). Each 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 Mary Boedeker'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 Mary Boedeker was last updated on January 3, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.