Boomer 06, PLLC
NPI 1871126383 · Physical Therapist · Oklahoma City, OK
Enrolled with Medicare as Part B Supplier - Physical/Occupational Therapy Group in Private Practice · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Boomer 06, PLLC is a Physical Therapist organization in Oklahoma City, OK (NPI 1871126383).
Provider details
- NPI number
- 1871126383
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Ryan Elassal, Physical Therapist(405) 996-0660
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Suppliers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
6 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
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
Other names (DBA / former)
- Doing business as
- The Mobile Therapy Group
- Doing business as
- The Mobile Therapy Group
Registry dates
- Enumerated
- 2020-02-13
- Last updated
- 2024-10-22
- Certified
- 2024-10-22
Frequently asked questions
- What is Boomer 06, PLLC's NPI number?
- Boomer 06, PLLC's National Provider Identifier (NPI) is 1871126383, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Boomer 06, PLLC?
- Boomer 06, PLLC is classified in the NPPES registry as Physical Therapist (Respiratory, Developmental, Rehabilitative and Restorative Service Providers).
- Where is Boomer 06, PLLC located?
- Boomer 06, PLLC's practice location on file with NPPES is 10921 S Western Ave Ste 200, Oklahoma City, OK 73170-6228.
- What is Boomer 06, PLLC's phone number?
- The practice phone number listed in the NPPES registry for Boomer 06, PLLC is (405) 996-0660.
- Does Boomer 06, PLLC accept Medicare?
- Boomer 06, PLLC 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 Boomer 06, PLLC?
- The authorized official listed on Boomer 06, PLLC's NPPES record is Ryan Elassal, Physical Therapist. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Boomer 06, PLLC's NPI active?
- Yes — Boomer 06, PLLC's NPI (1871126383) is active in the NPPES registry as of the last update on 2024-10-22.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.