Dr Michael Scott Boedefeld, MD | |
1055 Bowles Ave Ste 202, Fenton, MO 63026-2308 | |
(636) 386-7222 | |
(636) 386-7810 |
Full Name | Dr Michael Scott Boedefeld |
---|---|
Gender | Male |
Speciality | Interventional Pain Management |
Experience | 26 Years |
Location | 1055 Bowles Ave Ste 202, Fenton, Missouri |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043299548 | NPI | - | NPPES |
207320102 | Medicaid | MO |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207L00000X | Anesthesiology | 2004009978 (Missouri) | Secondary |
207LP2900X | Anesthesiology - Pain Medicine | 2004009978 (Missouri) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Ssm St Clare Health Center | Fenton, MO | Hospital |
Ssm St Joseph Health Center | Saint charles, MO | Hospital |
Ssm St Joseph Hospital West | Lake saint louis, MO | Hospital |
St Lukes Hospital | Chesterfield, MO | Hospital |
Barnes-jewish St Peters Hospital | Saint peters, MO | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Pro Pain Llc | 0941563225 | 5 |
Physical Therapy Spine And Sports Medicine Llc | 3173654936 | 86 |
Ssm Medical Group Inc | 6608776299 | 496 |
Entity Name | Ssm Medical Group Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1700966207 PECOS PAC ID: 6608776299 Enrollment ID: O20040729001034 |
Entity Name | Pro Pain Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205339074 PECOS PAC ID: 0941563225 Enrollment ID: O20180419001389 |
Mailing Address | Practice Location Address |
---|---|
Dr Michael Scott Boedefeld, MD 4800 Mexico Rd Ste 101, Saint Peters, MO 63376-1666 Ph: (636) 442-5035 | Dr Michael Scott Boedefeld, MD 1055 Bowles Ave Ste 202, Fenton, MO 63026-2308 Ph: (636) 386-7222 |
Stacey A Mormol, CRNA Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1015 Bowles Ave, Fenton, MO 63026 Phone: 636-496-2000 | |
Marlayna F Schaffer, CRNA Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1015 Bowles Ave, Fenton, MO 63026 Phone: 636-496-2000 | |
Dr. Cyrene D Grothaus-day, MD Anesthesiology Medicare: Accepting Medicare Assignments Practice Location: 1378 Mosswoods Dr, Fenton, MO 63026 Phone: 636-861-1676 |