Individual provider Active NPI

Emily Louise Boudeman, PT, DPT

  • Physical Therapist
  • West Chester, PA
National Provider Identifier
1538999800
Registry record updated Aug 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT032456 Issued in PA
Practice address
1502 W Chester Pike Ste 23
West Chester, PA 19382-7705
Phone
(610) 692-7208
NPI assigned
Aug 2, 2024
Last updated
Aug 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 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 PT032456 PA Primary

Addresses

Primary practice location

1502 W Chester Pike Ste 23
West Chester, PA 19382-7705

Mailing address

956 S Matlack St Apt 321
West Chester, PA 19382-7680
Phone (570) 560-3253

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250110002826 PA Practitioner - Physical Therapist in Private Practice 9537697099 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Novacare Outpatient Rehabilitation East Inc CurrentSince Dec 5, 2024 Accepting new patients
Novacare Outpatient Rehabilitation East, Inc. Physical Therapist Current Accepting new patients
Novacare Outpatient Rehabilitation East, Inc. CurrentSince Dec 5, 2024 Accepting new patients
Rehabclinics Galaxy Inc PastSince Aug 4, 2024 Accepting new patients

Locations

688 Downingtown Pike
West Chester, PA 19380
Phone (484) 787-0200

Organizations & group practices 4

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": "1722556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1538999800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "956 S MATLACK ST APT 321",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193827680",
            "telephone_number": "570-560-3253"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1502 W CHESTER PIKE STE 23",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193827705",
            "telephone_number": "610-692-7208"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDEMAN",
        "first_name": "EMILY",
        "middle_name": "LOUISE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-08-02",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT032456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Chester, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.