Michael Raymond Boulter, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT-1283 Issued in WY

Practice address

311 Thelma Dr
Casper, WY 82609-2325

Phone

(307) 234-2662

Fax

(307) 234-8810

NPI assigned

Aug 4, 2009

Last updated

Aug 4, 2009By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WY, NE2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Big Country Rehabilitation LLCGroup PAC ID 0648253666, 17 clinicians

North Platte Physical Therapy Services IncGroup PAC ID 8921080565, 34 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

74.96 of 100Reported as group

Quality

70.73

Improvement activities

40

Cost

70.19

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• North Platte Physical Therapy Services, Inc.

  • Physical Therapist
  • Douglas, WY
  • NPI 1093914111
  Medicare reassignment Care Compare group NPD
• Big Country Rehabilitation,LLC

  • Physical Therapist
  • Douglas, WY
  • NPI 1366493264
  Medicare reassignment Care Compare group
• Bear Lodge Rehabilitation Services, LLC

  • Physical Therapist
  • Sundance, WY
  • NPI 1558690099
  Medicare reassignment NPD
• Monument Physical Therapy, LLC

  • Physical Therapist
  • Gering, NE
  • NPI 1508190240
  Medicare reassignment NPD
• Memorial Hospital of Converse County

  • General Practice Physician
  • Douglas, WY
  • NPI 1356496491
  NPD (past)
• Northplatte Physical Therpy Services Inc

  • Physical Therapist
  • Casper, WY
  • NPI 1336190230
  NPD (past)

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

{
    "created_epoch": "1249344000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1249344000000",
    "number": "1265663587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1790",
            "city": "DOUGLAS",
            "state": "WY",
            "postal_code": "826331790",
            "telephone_number": "307-358-9464",
            "fax_number": "307-358-9330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 THELMA DR",
            "city": "CASPER",
            "state": "WY",
            "postal_code": "826092325",
            "telephone_number": "307-234-2662",
            "fax_number": "307-234-8810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULTER",
        "first_name": "MICHAEL",
        "middle_name": "RAYMOND",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-08-04",
        "last_updated": "2009-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WY",
            "license": "PT-1283",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Daniel Ryan Bonifield, D.O.
• Angela Lee Booth, APRN
• Travis Bopp
• Makala Raye Boren, MSW, PCSW
• Bottom Half, LLC
• John Lee Bouzis, D.D.S
• Rebecca Rae Bouzis, MSN, RN
• Abby Bowen-Rodda, PH.D.
• Lois Audel Bowen, MS, CADCII
• Teresa Bowen

• Physical Therapist in Casper, WY
• Providers in Casper, WY by specialty
• Physical Therapist in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2009; 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.