Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.
NPIDirectory

Mark Boodram, PT, DPT

Individual provider Orthopedic Physical Therapist · NPI 1255159463

Mark Boodram, PT, DPT is registered under Physical Therapist in Private Practice in New York, New York. Qualified in 2024, 2 years ago. Practices with Bespoke Treatments Physical Therapy PC, a 23-clinician group.

Years since qualifying
2
In the registry since
2024
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

138 5th Ave Fl 2
New York, NY 10011-4367
Phone: (646) 490-4002
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Orthopedic Physical Therapist (primary) Taxonomy 2251X0800X

Record details

NPI number1255159463
Entity typeIndividual (Type 1)
GenderMale
Credentials PT , DPT
Sole proprietorYes
NPI enumeratedSeptember 27, 2024
Last updated in NPPESSeptember 27, 2024
Certification dateSeptember 27, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Bespoke Treatments Physical Therapy Pc — 23 clinicians
Accepts Medicare assignment Not indicated

Colleagues at Bespoke Treatments Physical Therapy PC

Clinicians the CMS Doctors & Clinicians file lists under the same group practice. CMS counts 23 clinicians in the practice; 12 are shown here.

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