Individual provider Active NPI

Joseph Walter Boegemann, DPT

  • Physical Therapist
  • Auburn, ME
National Provider Identifier
1710559596
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT5947 Issued in ME
Practice address
690 Minot Ave Ste 2
Auburn, ME 04210-3922
Phone
(207) 783-3450
Fax
(207) 777-3979
NPI assigned
Jul 12, 2021
Sex
Male
Sole proprietor
No

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saco Bay Orthopaedic and Sports Physical Therapy Inc 137 clinicians

Practice addresses (Care Compare)

4 Commons Ave
Suite 4D
Windham, ME 04062-5554
Phone (207) 892-7642

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220318001211 ME Practitioner - Physical Therapist in Private Practice 6507251055 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc. CurrentSince Mar 1, 2022 Accepting new patients
Saco Bay Orthopaedic and Sports Physical Therapy, Inc Physical Therapist CurrentSince Mar 1, 2022 Accepting new patients

Locations

400 North St
#2
Saco, ME 04072
Phone (207) 282-7121

4 Commons Ave
Ste 4D
Windham, ME 04062
Phone (207) 590-5413

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X PT5947 ME Primary

Addresses

NPPES NPI Registry

Primary practice location

690 Minot Ave Ste 2
Auburn, ME 04210-3922

Mailing address

223 Flaggy Meadow Rd
Buxton, ME 04093-3763

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 12, 2021.

{
    "created_epoch": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1710559596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "223 FLAGGY MEADOW RD",
            "city": "BUXTON",
            "state": "ME",
            "postal_code": "040933763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 MINOT AVE STE 2",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042103922",
            "telephone_number": "207-783-3450",
            "fax_number": "207-777-3979"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEGEMANN",
        "first_name": "JOSEPH",
        "middle_name": "WALTER",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "ME",
            "license": "PT5947",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, ME

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.

Verify at the official NPI Registry.