Active NPI
Marcus A Boehm, DPT
- Physical Therapist
- Green Bay, WI
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14128-24
- Practice address
- 2502 S Ashland Ave
Green Bay, WI 54304-5252 - Phone
- (920) 496-4700
- NPI assigned
- Sep 8, 2017
- Last updated
- May 15, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 8594 | AL | |
| Physical Therapist | 225100000X | 14128-24 | WI | Primary |
Addresses
Primary practice location
2502 S Ashland Ave
Green Bay, WI 54304-5252
Mailing address
PO Box 19070
Green Bay, WI 54307-9070
Phone (920) 496-4700
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100083986 | Medicaid | WI |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | mboehm474018@ewd.direct.hshs.org | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WI
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
2502 S Ashland Ave
Green Bay, WI 54304-5252
Phone (920) 496-4700
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8594 | AL | MD | Physical Therapist |
Practice roles
Locations
1510 Fremont St
Algoma, WI 54201
Phone (920) 487-3676
831 Parker Ave
Algoma, WI 54201
Phone (920) 487-3084
2502 S Ashland Ave
Green Bay, WI 54304
Phone (920) 496-4750
744 S Webster Ave
Green Bay, WI 54301
Phone (920) 433-6025
744 S Webster Ave
Fl 7
Green Bay, WI 54301
835 S Van Buren St
Green Bay, WI 54301
Phone (888) 901-7246
1765 N 18th St
Manitowoc, WI 54220
Phone (920) 482-0575
2820 Roosevelt Rd
Marinette, WI 54143
Phone (715) 330-6171
820 Arbutus Ave
Oconto, WI 54153
Phone (920) 835-1100
3100 Superior Ave
Sheboygan, WI 53081
Phone (800) 472-6710
Interoperability endpoints
- mboehm204478@direct.thedacare.org
Organizations & group practices 12
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.
-
dba Prevea Health
- General Practice Physician
- Green Bay, WI
- NPI 1285613638
Physical Therapist
-
dba Bellin Health Algoma
- Rural Health Clinic/Center
- Algoma, WI
- NPI 1609838473
-
dba Emplify Health Oconto Hospital
- Critical Access Hospital
- Oconto, WI
- NPI 1356373302
-
dba Prevea Sheboygan Health Center
- Internal Medicine Physician
- Sheboygan, WI
- NPI 1275799413
Physical Therapist
-
dba Bellin Health
- Family Medicine Physician
- Green Bay, WI
- NPI 1033172390
Physical Therapist
-
dba Bellin Health Suring
- Rural Health Clinic/Center
- Suring, WI
- NPI 1104418037
-
dba Bellin Health Crivitz
- Rural Health Clinic/Center
- Crivitz, WI
- NPI 1174971725
-
dba St Nicholas Hospital Professional Services Group
- Nurse Practitioner
- Sheboygan, WI
- NPI 1275943243
-
dba St. Nicholas Hospital
- Internal Medicine Physician
- Sheboygan, WI
- NPI 1447737762
-
dba Prevea Health ENT
- Otolaryngology Physician
- Shawano, WI
- NPI 1194314013
-
dba Prevea Health
- Durable Medical Equipment & Medical Supplies
- Green Bay, WI
- NPI 1245042530
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1504828800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747267200000",
"number": "1356869416",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 19070",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543079070",
"telephone_number": "920-496-4700"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2502 S ASHLAND AVE",
"city": "GREEN BAY",
"state": "WI",
"postal_code": "543045252",
"telephone_number": "920-496-4700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOEHM",
"first_name": "MARCUS",
"middle_name": "A",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-08",
"last_updated": "2025-05-15",
"certification_date": "2025-05-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "AL",
"license": "8594",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WI",
"license": "14128-24",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100083986",
"state": "WI"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "mboehm474018@ewd.direct.hshs.org",
"affiliation": "N",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "2502 S Ashland Ave",
"city": "Green Bay",
"state": "WI",
"country_code": "US",
"postal_code": "543045252",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Green Bay, WI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2025; 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.