Mrs Stacey Marie Boster, MS,PT - Medicare Physical Therapist in Russellville, AR

Mrs Stacey Marie Boster, MS,PT is a medicare enrolled "Physical Therapist" provider in Russellville, Arkansas. She graduated from medical school in 2002 and has 22 years of diverse experience with area of expertise as Physical Therapy. She is a member of the group practice Lane Physical Therapy Center, Inc and her current practice location is 3016 W. Main Street, Suite 200, Russellville, Arkansas. You can reach out to her office (for appointments etc.) via phone at (479) 967-9657.

Mrs Stacey Marie Boster is licensed to practice in Arkansas (license number PT2554) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1053319715.

Contact Information

Mrs Stacey Marie Boster, MS,PT
3016 W. Main Street, Suite 200,
Russellville, AR 72801
(479) 967-9657
(479) 967-9658



Healthcare Provider's Profile

Full NameMrs Stacey Marie Boster
GenderFemale
SpecialityPhysical Therapy
Experience22 Years
Location3016 W. Main Street, Russellville, Arkansas
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Mrs Stacey Marie Boster graduated from medical school in 2002
  NPI Data:
  • NPI Number: 1053319715
  • Provider Enumeration Date: 07/07/2005
  • Last Update Date: 09/28/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 7012186455
  • Enrollment ID: I20110801000877

Medical Identifiers

Medical identifiers for Mrs Stacey Marie Boster such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1053319715NPI-NPPES
145572721MedicaidAR

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
225100000XPhysical Therapist PT2554 (Arkansas)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Lane Physical Therapy Center, Inc14562468184

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Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mrs Stacey Marie Boster allows following entities to bill medicare on her behalf.
Provider NameLane Physical Therapy Center, Inc
Provider TypePart B Supplier - Clinic/group Practice
Provider IdentifiersNPI Number: 1104855261
PECOS PAC ID: 1456246818
Enrollment ID: O20040216001171

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mrs Stacey Marie Boster is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mrs Stacey Marie Boster, MS,PT
1520 E 13th St,
Russellville, AR 72802-7437

Ph: (479) 967-9657
Mrs Stacey Marie Boster, MS,PT
3016 W. Main Street, Suite 200,
Russellville, AR 72801

Ph: (479) 967-9657

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Physical Therapist in Russellville, AR

Seth B. Coulter, P.T.
Physical Therapist
Medicare: Medicare Enrolled
Practice Location: 115 Skyline Dr, Suite A, Russellville, AR 72802
Phone: 479-967-5155    Fax: 479-967-5141
Ms. Brandi Nicole Koch, PT, DPT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 1301 Russell Rd, Russellville, AR 72802
Phone: 479-967-2316    Fax: 479-967-3639
Jacqueline Miller, PT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 500 E 3rd St, Russellville, AR 72801
Phone: 479-968-1198    Fax: 479-967-1178
Nicholas Paul Lensing, PT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 301 N Sidney Ave, Russellville, AR 72801
Phone: 479-890-5494    Fax: 479-967-0069
Mr. Jerry Wayne Manning, PT
Physical Therapist
Medicare: Accepting Medicare Assignments
Practice Location: 3016 W Main St Ste 200, Russellville, AR 72801
Phone: 479-967-9657    Fax: 479-967-9658
Kimberly D Mcdougal, PT
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 301 Reasoner Ln, Russellville, AR 72802
Phone: 479-970-2175    Fax: 479-964-2126
Allison Young, P.T.
Physical Therapist
Medicare: Not Enrolled in Medicare
Practice Location: 500 E 3rd St, Russellville, AR 72801
Phone: 479-968-1198    

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