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Individual provider Active NPI

Abigail Boduch, MD

  • Orthopaedic Surgery Physician
  • Pittsburgh, PA
National Provider Identifier
1558890186
Registry record updated May 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopaedic Surgery PhysicianTaxonomy code 207X00000X
License
MD18291 Issued in RI
Practice address
Upmc Freddie Fu Sports Medicine Center
3200 South Water Street
Pittsburgh, PA 15203
Phone
(401) 443-4205
NPI assigned
Jun 7, 2017
Last updated
May 17, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopaedic Surgery Physician 207X00000X MD18291 RI Primary

Addresses

Primary practice location

Upmc Freddie Fu Sports Medicine Center
3200 South Water Street
Pittsburgh, PA 15203

Mailing address

3600 Forbes Ave.
Forbes Tower Plaza Level Suite 140
Pittsburgh, PA 15213

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH, ME2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240904002669 NH Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 4183993645 Reassigns benefits to 1 organization
I20240904002891 ME Practitioner - Orthopedic SurgeryPractitioner - Sports Medicine 4183993645 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Orthopedic SurgeryAlso: Sports Medicine
Education
Pennsylvania State University College of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

16 Hospital Dr
Suite B
York, ME 03909-1041
Phone (207) 363-3490

1900 Lafayette Rd
Suite a
Portsmouth, NH 03801-5679
Phone (603) 431-1121

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Lower limb (leg) arthroscopy (minimally invasive joint repair)1-10
Upper limb (arm) arthroscopy (minimally invasive joint repair)1-10
Melanoma (skin cancer) excision1-10
Removal of tissue16

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sportsmedicine Atlantic Orthopaedics PA Orthopaedic Surgery CurrentSince Aug 23, 2024 Accepting new patients
Sportsmedicine Atlantic Orthopaedics PA Orthopaedic Surgery CurrentSince Aug 23, 2024 Accepting new patients

Locations

16 Hospital Dr
Ste B
York, ME 03909
Phone (207) 351-8117

15 Durham Rd
Ste 108
Dover, NH 03820
Phone (603) 431-1121

1900 Lafayette Rd
Ste A
Portsmouth, NH 03801
Phone (603) 431-1121

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.

Hospital & facility affiliations 9

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684281600000",
    "number": "1558890186",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3600 FORBES AVE.",
            "address_2": "FORBES TOWER PLAZA LEVEL SUITE 140",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "UPMC FREDDIE FU SPORTS MEDICINE CENTER",
            "address_2": "3200 SOUTH WATER STREET",
            "city": "PITTSBURGH",
            "state": "PA",
            "postal_code": "15203",
            "telephone_number": "401-443-4205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BODUCH",
        "first_name": "ABIGAIL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-06-07",
        "last_updated": "2023-05-17",
        "certification_date": "2023-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "RI",
            "license": "MD18291",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pittsburgh, PA

Sources for this page

Verify at the official NPI Registry.