Individual provider Active NPI

Ericka Boeger, PT, DPT

  • Physical Therapist
  • Gilbert, AZ
National Provider Identifier
1174354328
Registry record updated Aug 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
033727 Issued in AZ
Practice address
3961 E Guadalupe Rd Ste 1
Gilbert, AZ 85234-3266
Phone
(480) 699-4845
NPI assigned
Aug 9, 2024
Last updated
Aug 9, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 9, 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 033727 AZ Primary

Addresses

Primary practice location

3961 E Guadalupe Rd Ste 1
Gilbert, AZ 85234-3266

Mailing address

702 E Secretariat Dr
Tempe, AZ 85284-1451
Phone (480) 202-6665

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240821003619 AZ Practitioner - Physical Therapist in Private Practice 1254879224 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Advanced Neurologic RehabilitationGroup PAC ID 5395055859, 34 clinicians

Practice addresses (Care Compare)

3961 E Guadalupe Rd
Suite 1
Gilbert, AZ 85234-3266
Phone (480) 699-4845

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
033727AZMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Neurologic Rehabilitation CurrentSince Aug 7, 2024 Accepting new patients
Advanced Neurologic Rehabilitation PastSince Sep 11, 2022 Accepting new patients

Locations

3160 N Arizona Ave
Ste 106
Chandler, AZ 85225
Phone (480) 699-4845

3961 E Guadalupe Rd
Ste 1
Gilbert, AZ 85234
Phone (480) 699-4845

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1723161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723161600000",
    "number": "1174354328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 E SECRETARIAT DR",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "852841451",
            "telephone_number": "480-202-6665"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3961 E GUADALUPE RD STE 1",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852343266",
            "telephone_number": "480-699-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEGER",
        "first_name": "ERICKA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-08-09",
        "last_updated": "2024-08-09",
        "certification_date": "2024-08-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "033727",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gilbert, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 9, 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.