Patricia M. Boever, PSYCHOLOGIST

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY00151 Issued in MO

Practice address

8772 Big Bend Blvd
Saint Louis, MO 63119-3730

Phone

(314) 962-7788

Fax

(314) 962-4158

NPI assigned

May 24, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Enrolled in MO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1972

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Creative Change, LLC 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Creative Change, LLC

  • Clinical Psychologist
  • Ellisville, MO
  • NPI 1760515498

  Clinical, MO

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1148428800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1195084800000",
    "number": "1073568069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8772 BIG BEND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631193730",
            "telephone_number": "314-962-7788",
            "fax_number": "314-962-4158"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8772 BIG BEND BLVD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631193730",
            "telephone_number": "314-962-7788",
            "fax_number": "314-962-4158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEVER",
        "first_name": "PATRICIA",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "PSYCHOLOGIST",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-24",
        "last_updated": "2007-11-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "PY00151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "143241",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "886503",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "009001",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MANAGED HEALTH NETWORK",
            "identifier": "286897",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA BEHAVIORAL HEALTH",
            "identifier": "44494",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA BEHAVIORAL HEALTH",
            "identifier": "5935265",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MERCY HEALTH PLANS",
            "identifier": "R00664",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "17912",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DIV OF FAMILY SEVCS",
            "identifier": "399033",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN BEHAVIORAL HEALT",
            "identifier": "458408",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Anna Huff Boerwinkle, MD
• Tanner William Boes, MD
• Karen R Boesch, MD
• Molly Boesch
• Carmen C Boeser, PHD
• Michael Anthony Boeving, MD
• Katherine Elizabeth Bogan, OT
• Pamela Elise Bogan, RN
• Margaret Jane Bogart, OTD, OTR/L
• Peter Bogart, LPC, NCC

• All providers in Saint Louis, MO
• Clinical Psychologist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.