David Henry Boedeker

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

0102207378 Issued in VA

Practice address

4494 North Palmer Road
Bethesda, MD 20889-0001

Phone

(402) 213-3106

NPI assigned

Jan 12, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: dboedeker2128370@direct.trinity-health.org

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

{
    "created_epoch": "1610409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1720483200000",
    "number": "1548859804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4494 NORTH PALMER ROAD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "402-213-3106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4494 NORTH PALMER ROAD",
            "city": "BETHESDA",
            "state": "MD",
            "postal_code": "208890001",
            "telephone_number": "402-213-3106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEDEKER",
        "first_name": "DAVID",
        "middle_name": "HENRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-12",
        "last_updated": "2024-07-09",
        "certification_date": "2024-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0102207378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beatrice Ekua Boateng
• Kevin Andrew Bobeck, MD
• Ralph V Boccia, M.D.
• Guillemette Bodenreider
• Caroline Cruz Bodner, ACNP
• Jamie Boehm
• Justin Michael Boehm
• Martin Lewis Boese, CRNA
• Bradley John Boetig, MD
• Nathan Allen Boggs, M.D.

• General Practice Physician in Bethesda, MD
• Providers in Bethesda, MD by specialty
• General Practice Physician in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 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; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.