Stephen Boettke, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305215238 Issued in VA

Practice address

2960 Chain Bridge Rd Ste 201
Oakton, VA 22124-3040

Phone

(703) 242-6460

Fax

(703) 242-6463

NPI assigned

Aug 8, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DC, VA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Jackson Clinics Limited Partnership 116 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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 and National Provider Directory roles.

• Jackson Clinics Limited Partnership

  • Physical Therapist
  • Centreville, VA
  • NPI 1639594831

  DC, Physical Therapist, VA

  Medicare reassignment Care Compare group NPD
• The Jackson Clinics LLC

  • Physical Therapist
  • Middleburg, VA
  • NPI 1427034982
  NPD (past)

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

{
    "created_epoch": "1659916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659916800000",
    "number": "1942937065",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1769",
            "city": "MIDDLEBURG",
            "state": "VA",
            "postal_code": "201181769",
            "telephone_number": "703-242-6460",
            "fax_number": "703-242-6463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2960 CHAIN BRIDGE RD STE 201",
            "city": "OAKTON",
            "state": "VA",
            "postal_code": "221243040",
            "telephone_number": "703-242-6460",
            "fax_number": "703-242-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOETTKE",
        "first_name": "STEPHEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-08",
        "last_updated": "2022-08-08",
        "certification_date": "2022-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305215238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joseph P Bartling
• Cristina Marie Belmonte
• Nathaniel Joseph Berman
• Maryam Birjandi, RPH
• Blue Sky Health and Wellness
• Alberto Andres Borges, M.D.
• Arianne Bozarth, CNS
• Kristine D Brook, FNP-BC
• Sarah Brooks, ATC, VATL
• Erinn Burakow

• All providers in Oakton, VA
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2022; 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.