Pro Pain LLC
NPI 1205339074 · Pain Medicine (Anesthesiology) Physician · Fenton, MO
Enrolled with Medicare as Part B Supplier - Clinic/Group Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Pro Pain LLC is a Pain Medicine (Anesthesiology) Physician organization in Fenton, MO (NPI 1205339074).
Provider details
- NPI number
- 1205339074
- Entity type
- Organization
- Primary specialty
- Pain Medicine (Anesthesiology) PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Michael Boedefeld, Owner(636) 442-5035
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 4800 Mexico RdSaint Peters, MO 63376Phone: (636) 442-5036
Registry dates
- Enumerated
- 2018-03-17
- Last updated
- 2018-12-06
Frequently asked questions
- What is Pro Pain LLC's NPI number?
- Pro Pain LLC's National Provider Identifier (NPI) is 1205339074, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Pro Pain LLC?
- Pro Pain LLC is classified in the NPPES registry as Pain Medicine (Anesthesiology) Physician (Allopathic & Osteopathic Physicians).
- Where is Pro Pain LLC located?
- Pro Pain LLC's practice location on file with NPPES is 1055 Bowles Ave Ste 202, Fenton, MO 63026-2308.
- What is Pro Pain LLC's phone number?
- The practice phone number listed in the NPPES registry for Pro Pain LLC is (636) 326-7821.
- Does Pro Pain LLC accept Medicare?
- Pro Pain LLC is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Who is the authorized official for Pro Pain LLC?
- The authorized official listed on Pro Pain LLC's NPPES record is Michael Boedefeld, Owner. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Pro Pain LLC's NPI active?
- Yes — Pro Pain LLC's NPI (1205339074) is active in the NPPES registry as of the last update on 2018-12-06.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.