Active NPI
Ben Harold Boedeker, MD
- Anesthesiology Physician
- Omaha, NE
National Provider Identifier
1578646170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 4173A
- Practice address
- 4101 Woolworth Ave MSC 118
Omaha, NE 68105-1850 - Phone
- (402) 346-8800
- Fax
- (402) 943-5508
- NPI assigned
- Oct 24, 2006
- Last updated
- Jul 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 4173A | WY | Primary |
Addresses
Primary practice location
4101 Woolworth Ave MSC 118
Omaha, NE 68105-1850
Mailing address
4101 Woolworth Ave MSC 118
Omaha, NE 68105-1850
Phone (402) 346-8800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4173A | WY | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Au Medical Associates Anesthesia Billing Services, LLC | Anesthesiology | Past | Accepting new patients |
Organizations & group practices 1
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 MCG Anesthesiology Financial Services
- Anesthesiology Physician
- Augusta, GA
- NPI 1801843933
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1578646170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4101 WOOLWORTH AVE MSC 118",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051850",
"telephone_number": "402-346-8800",
"fax_number": "402-943-5508"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4101 WOOLWORTH AVE MSC 118",
"city": "OMAHA",
"state": "NE",
"postal_code": "681051850",
"telephone_number": "402-346-8800",
"fax_number": "402-943-5508"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOEDEKER",
"first_name": "BEN",
"middle_name": "HAROLD",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-10-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "WY",
"license": "4173A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Omaha, NE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.