Individual provider Active NPI

Abigail Lynn Boensch, PT, DPT

  • Physical Therapist
  • Tawas City, MI
National Provider Identifier
1073079919
Registry record updated Oct 1, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5501019016 Issued in MI
Practice address
540 W Lake St Ste 3
Tawas City, MI 48763-5101
Phone
(989) 984-6075
NPI assigned
Feb 15, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5501019016 MI Primary

Addresses

Primary practice location

540 W Lake St Ste 3
Tawas City, MI 48763-5101

Mailing address

732 W Anschuetz Dr
Tawas City, MI 48763-8600
Phone (989) 254-2245

Other practice location 1

732 W Anschuetz Dr
Tawas City, MI 48763-8600
Phone (989) 254-2245

Other practice location 2

3000 Centerpoint Pkwy
Pontiac, MI 48341-3116
Phone (248) 857-6776

Other names 1

  • Abigail Myles Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190318000368 MI Practitioner - Physical Therapist in Private Practice 9931449683 Reassigns benefits to 8 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Renue 018 Tawas, LLCGroup PAC ID 1759779853, 10 clinicians
Renue 003 Saginaw LLCGroup PAC ID 4981870870, 15 clinicians

Practice addresses (Care Compare)

540 W Lake St
Suite 3
Tawas City, MI 48763-5101
Phone (989) 984-6075

540 W Lake Ste
3 Renue 018 Tawas LLC
Tawas City, MI 48763-5101
Phone (989) 984-6075

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Renue 006 Saginaw State St LLC Physical Therapist CurrentSince Oct 23, 2024 Accepting new patients
Renue 012 Essexville, LLC Physical Therapist CurrentSince Oct 23, 2024 Accepting new patients
Renue 004 Bridgeport, LLC Physical Therapist CurrentSince Oct 23, 2024 Accepting new patients
Renue 002 Bay City LLC Physical Therapist CurrentSince Oct 23, 2024 Accepting new patients
Renue 003 Saginaw LLC Physical Therapist CurrentSince Oct 8, 2024 Accepting new patients
Renue 001 Freeland LLC Physical Therapist CurrentSince Oct 23, 2024 Accepting new patients
Renue 018 Tawas, LLC Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Renue 009 Midland LLC Physical Therapist CurrentSince Oct 23, 2024 Accepting new patients

Locations

401 E Huron Rd
Au Gres, MI 48703
Phone (989) 254-6360

4760 Garfield Rd
Ste B
Auburn, MI 48611
Phone (989) 662-8855

2618 Center Ave
Bay City, MI 48708
Phone (989) 450-3341

225 Washington Ave
Bay City, MI 48708
Phone (989) 895-4340

3720 Wilder Rd
Ste D
Bay City, MI 48706
Phone (989) 402-1215

804 N Water St
Bay City, MI 48708
Phone (989) 450-3341

5460 W Rolling Hills Dr
Bridgeport, MI 48722
Phone (989) 272-4500

406 W Genesee St
Ste B
Frankenmuth, MI 48734
Phone (989) 480-8872

7329 Industrial Dr
Freeland, MI 48623
Phone (989) 573-8266

2520 W Wackerly St
Midland, MI 48640
Phone (989) 423-1240

4431 N US Highway 23
Oscoda, MI 48750
Phone (989) 254-6455

4616 State St
Saginaw, MI 48603
Phone (989) 355-1010

3901 Bay Rd
Saginaw, MI 48603
Phone (989) 401-5282

1915 Fordney St
Saginaw, MI 48601
Phone (989) 355-1010

8680 Gratiot Rd
Ste B
Saginaw, MI 48609
Phone (989) 401-4791

540 W Lake St
Ste 3
Tawas City, MI 48763
Phone (989) 984-6075

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1550188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727740800000",
    "number": "1073079919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "732 W ANSCHUETZ DR",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487638600",
            "telephone_number": "989-254-2245"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "540 W LAKE ST STE 3",
            "city": "TAWAS CITY",
            "state": "MI",
            "postal_code": "487635101",
            "telephone_number": "989-984-6075"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "732 W Anschuetz Dr",
            "address_purpose": "LOCATION",
            "city": "Tawas City",
            "state": "MI",
            "postal_code": "487638600",
            "country_code": "US",
            "telephone_number": "989-254-2245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3000 Centerpoint Pkwy",
            "address_purpose": "LOCATION",
            "city": "Pontiac",
            "state": "MI",
            "postal_code": "483413116",
            "country_code": "US",
            "telephone_number": "248-857-6776",
            "fax_number": "248-857-7102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOENSCH",
        "first_name": "ABIGAIL",
        "middle_name": "LYNN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-15",
        "last_updated": "2024-10-01",
        "certification_date": "2024-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501019016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ABIGAIL",
            "last_name": "MYLES",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Tawas City, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.