Individual provider Active NPI

Robert W Boezinger, LCSW

  • Clinical Social Worker
  • Cedar Falls, IA
National Provider Identifier
1750343265
Registry record updated Sep 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149-011762 Issued in IL
Practice address
604 Clay St
Cedar Falls, IA 50613-2971
Phone
(563) 340-6545
NPI assigned
Apr 3, 2006
Last updated
Sep 1, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 1, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149-011762 IL Primary

Addresses

Primary practice location

604 Clay St
Cedar Falls, IA 50613-2971

Mailing address

1101 Lakeview Dr
Cedar Falls, IA 50613-1759
Phone (563) 340-6545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230828000921 IA Practitioner - Clinical Social Worker 2769480342 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

604 Clay St
Cedar Falls, IA 50613-2971
Phone (563) 340-6545

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149-011762ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Robert Boezinger, PLLC Clinical CurrentSince Jul 8, 2023 Accepting new patients
Olive Branch Counseling Services PLLC Clinical CurrentSince Apr 1, 2024 Accepting new patients

Locations

604 Clay St
Cedar Falls, IA 50613
Phone (563) 340-6545

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.

NPI Registry JSON

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

{
    "created_epoch": "1144022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693526400000",
    "number": "1750343265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 LAKEVIEW DR",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506131759",
            "telephone_number": "563-340-6545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 CLAY ST",
            "city": "CEDAR FALLS",
            "state": "IA",
            "postal_code": "506132971",
            "telephone_number": "563-340-6545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOEZINGER",
        "first_name": "ROBERT",
        "middle_name": "W",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-04-03",
        "last_updated": "2023-09-01",
        "certification_date": "2023-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149-011762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Falls, IA

Sources for this page

Verify at the official NPI Registry.