David Alden Boedeker, PA-C
NPI 1508311085ActiveIndividual· Physician Assistant, Medical· Lansing, MI
Physician Assistant, Medical (PA-C) with Black Hills Orthopedic and Spine Center Inc and 1 other group, practicing in Lansing, Michigan. Enrolled in Medicare as practitioner - physician assistant and practitioner - physician assistant. Lists Black Hills Surgical Hospital LLC and 1 other hospital as hospital affiliations.
Overview
| NPI | 1508311085 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Aug 24, 2016 |
| Last updated in NPPES | Oct 4, 2021 |
| Certified by provider | Oct 4, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | PT696 | WY |
| Physician Assistant, Medical | 363AM0700X | 5601008520 | MI |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (MI); Practitioner - Physician Assistant (SD); Practitioner - Physician Assistant (WY) |
|---|
Education and affiliations
| Graduation year | 2016 |
|---|---|
| Medicare specialty | Physician Assistant |
Medical groups
- Black Hills Orthopedic and Spine Center IncRapid City, SD · 72 clinicians
- Black Hills Orthopedic and Spine Center of Wyoming PCGillette, WY · 10 clinicians
Hospital affiliations
- Black Hills Surgical Hospital LLCRapid City, SD
- Monument Health Rapid City HospitalRapid City, SD
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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