Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Beau Boedecker, PA-C

Individual provider Physician Assistant · NPI 1093012734

Mr. Beau Boedecker, PA-C is a Physician Assistant in Milwaukee, Wisconsin. Qualified in 2010, 16 years ago. Practices with Aurora Medical Group, Inc, a 3,741-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
16
Licensed in
WI
In the registry since
2011
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

2801 W Kinnickinnic River Pkwy Ste 550
Milwaukee, WI 53215-3696
Phone: (414) 385-7150
Fax: (414) 385-7159
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 2701-23 (WI)

Record details

NPI number1093012734
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedFebruary 15, 2011
Last updated in NPPESJanuary 3, 2022
Certification dateJanuary 3, 2022

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Aurora Medical Group, Inc. — 3741 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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