Samantha Lynn Boman, PT
Individual provider Active NPI Physical Therapist · Waterloo, IL
NPI 1851830236 · NPPES record last updated Dec 11, 2019
Key facts
- NPI
- 1851830236
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 070022815 (IL)
- Practice address
- 509 Hamacher St
Suite101
Waterloo, IL 62298-1592 - Phone
- (618) 939-5555
- NPI assigned
- Feb 17, 2017
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 10
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Athletic and Therapeutic Institute of Bourbonnais, LLC
Practice addresses (Care Compare)
1000 Eleven S
Suite 1B
Columbia, IL 62236-1078
Phone (618) 281-9699
1275 N Convent St
Suite 3
Bourbonnais, IL 60914-8211
Phone (815) 936-1855
1514 S Main St
Suite 4
Red Bud, IL 62278-1382
Phone (618) 282-5555
180 Waterloo Commons Dr
Waterloo, IL 62298-1081
Phone (618) 939-5555
327 W Washington St
Millstadt, IL 62260-1159
Phone (618) 476-9444
Merit-based Incentive Payment System (MIPS)
- Final score
- 85.61 of 100
- Quality
- 90
- Improvement activities
- 40
- Cost
- 70.36
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IL
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170221000235 | IL | Practitioner - Physical Therapist in Private Practice | 8921382813 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Athletic and Therapeutic Institute of Bourbonnais, LLC | Physical Therapist | Current |
Accepting new patients |
| Athletic and Therapeutic Institute of Bourbonnais, LLC | Physical Therapist | Current |
Accepting new patients |
| Athletic and Therapeutic Institute of Naperville, LLC | Physical Therapist | Current |
Accepting new patients |
| Athletic and Therapeutic Institute of Naperville LLC | Physical Therapist | Current | Accepting new patients |
| Athletic and Therapeutic Institute of Naperville, LLC | Current |
Accepting new patients | |
| FLS Physical Therapy Associates PC | Physical Therapist | Past |
Accepting new patients |
Locations
383 W Army Trail Rd
Ste 100
Bloomingdale, IL 60108
Phone (630) 924-0367
790 Remington Blvd
Bolingbrook, IL 60440
1275 N Convent St
Ste 3
Bourbonnais, IL 60914
Phone (815) 936-1855
4947 Paysphere Cir
Chicago, IL 60674
Phone (630) 783-2001
800 Des Plaines Ave
Forest Park, IL 60130
Phone (708) 366-2442
2081 Ridge Rd
Ste 101
Minooka, IL 60447
Phone (815) 467-1612
2325 W Monroe St
Springfield, IL 62704
Phone (217) 241-0270
509 Hamacher St
Ste 101
Waterloo, IL 62298
Phone (618) 939-5555
967 N Green Bay Rd
Waukegan, IL 60085
Phone (224) 321-5237
109 W Geneva Rd
Wheaton, IL 60187
Phone (630) 784-3251
0S050 Winfield Rd
Ste 120
Winfield, IL 60190
Phone (630) 653-4743
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 070022815 | IL | Yes |
Addresses
Primary practice location
509 Hamacher St
Suite101
Waterloo, IL 62298-1592
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223
Other names
- Samantha Kruse
Other providers in Waterloo, IL
- Taylor Becker
- Allison Zoe Biffar
- Sarah Lynn Birkner
- John F Blattner
- Lauren E Blodgett
- Kara Bordeaux
- Michele Bowen
- Marolene Bowling
- Sharon Brand
- Hannah Irene Brasier
All providers in Waterloo, IL · Physical Therapist in Illinois
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 11, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.