Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mr. David Alden Boedeker, PA-C

Individual provider Medical Physician Assistant · NPI 1508311085

Mr. David Alden Boedeker, PA-C is a Physician Assistant in Lansing, Michigan. Qualified in 2016, 10 years ago. Practices with Black Hills Orthopedic and Spine Center of Wyoming PC, a 12-clinician group and accepts Medicare assignment. Licensed in Michigan and Wyoming.

Years since qualifying
10
Licensed in
MI, WY
In the registry since
2016
Specialties on file
2
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

2815 S Pennsylvania Ave Ste 204
Lansing, MI 48910-3496
Phone: (517) 267-0200
Fax: (517) 267-1877
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Medical Physician Assistant (primary) Taxonomy 363AM0700X · Licence PT696 (WY)
Medical Physician Assistant Taxonomy 363AM0700X · Licence 5601008520 (MI)

Record details

NPI number1508311085
Entity typeIndividual (Type 1)
GenderMale
Credentials PA-C
Sole proprietorNo
NPI enumeratedAugust 24, 2016
Last updated in NPPESOctober 4, 2021
Certification dateOctober 4, 2021

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Black Hills Orthopedic And Spine Center Of Wyoming Pc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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