Pro Pain LLC
NPI 1205339074ActiveOrganization· Anesthesiology, Pain Medicine· Fenton, MO
Anesthesiology, Pain Medicine in Fenton, Missouri, registered in NPPES in March 2018. The authorized official on file is Michael Boedefeld, MD, Owner. Enrolled in Medicare as dme supplier - physician - interventional pain management and part b supplier - clinic/group practice.
Overview
| NPI | 1205339074 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Mar 17, 2018 |
| Last updated in NPPES | Dec 6, 2018 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Anesthesiology, Pain Medicine Primary | 207LP2900X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled DME Supplier - Physician - Interventional Pain Management (MO); Part B Supplier - Clinic/Group Practice (MO) |
|---|
Other pain medicine anesthesiologists in Fenton
- 1043299548