Benjamin David Boodt, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

01088947A Issued in IN

Practice address

2100 Powell St Ste 400
Emeryville, CA 94608-1872

Phone

(510) 350-2600

NPI assigned

Mar 28, 2020

Last updated

Jun 30, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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 IN

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

Specialty

Emergency Medicine

Education

Indiana University School of Medicine, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cep America LLCGroup PAC ID 6608056171, 995 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Carmel Hospital, Carmel, IN, CCN 150157
• Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
• Ascension St Vincent Fishers Hospital, Fishers, IN, CCN 150181
• Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010

Merit-based Incentive Payment System (MIPS)

Final score

87.3 of 100Reported as group

Quality

70.94

Improvement activities

40

Cost

92.94

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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.

• Cep America LLC

  • Emergency Medicine Physician
  • Terre Haute, IN
  • NPI 1285103671
  Medicare reassignment Care Compare group NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Indianapolis, IN
  • NPI 1548912553
  NPD
• Cep America LLC

  • Emergency Medicine Physician
  • Fort Lauderdale, FL
  • NPI 1700747946
  NPD

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

• St Vincent Fishers Hospital Inc

  dba Ascension St Vincent Fishers

  • General Acute Care Hospital
  • Fishers, IN
  • NPI 1881956167
  Care Compare affiliation
• St. Joseph Hospital & Health Center, Inc.

  dba Ascension St. Vincent Kokomo

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1780625442
  Care Compare affiliation
• St. Vincent Carmel Hospital, Inc.

  dba Ascension St. Vincent Carmel

  • General Acute Care Hospital
  • Carmel, IN
  • NPI 1639124134
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent Hospital

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1306898960
  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  dba Ascension St. Vincent - Avon

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1851833230
  Care Compare affiliation

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

{
    "created_epoch": "1585353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1688083200000",
    "number": "1780212514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 400",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081872",
            "telephone_number": "510-350-2600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 POWELL ST STE 400",
            "city": "EMERYVILLE",
            "state": "CA",
            "postal_code": "946081872",
            "telephone_number": "510-350-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3525 Southern Blvd",
            "address_purpose": "LOCATION",
            "city": "Kettering",
            "state": "OH",
            "postal_code": "454291221",
            "country_code": "US",
            "telephone_number": "937-395-8839",
            "fax_number": "937-395-8387",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOODT",
        "first_name": "BENJAMIN",
        "middle_name": "DAVID",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-28",
        "last_updated": "2023-06-30",
        "certification_date": "2023-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IN",
            "license": "01088947A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Janika Boguszewski Rodriguez, ASW
• Austin Bohnsack, DC
• Khaliyah Em Bolden
• Sherricia Bonds
• Mikaela Ashley Encontro Bongcaron
• Haydee Antonia Bowden, BCBA
• Benjamin Samuel Boyd, P.T.
• Carolina Bracamonte-Espinoza
• Charita Bradshaw
• Lucky Abdullah Braimah

• Emergency Medicine Physician in Emeryville, CA
• Providers in Emeryville, CA by specialty
• Emergency Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2023; 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.
• 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.