EMANUEL LUCIAN BOAR (PT) – Physical Therapist, NPI 1972165272

EMANUEL LUCIAN BOAR (PT) is a healthcare provider. based in Fort wayne, Indiana. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. 99094140A (IN). The NPI Number for EMANUEL LUCIAN BOAR (PT) is 1972165272

Main info

Male
7 Years Of Experience
Accepts Medicare Assignment
Name
EMANUEL LUCIAN BOAR (PT)
NPI
1972165272
Phone
(260) 255-6494
Address
4106 MERCHANT RD RM A
Enumeration Date
8 July 2019
Last Update Date
18 August 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
2604899887
Graduation Year
2019 (7 years ago)
PAC ID
9638501372
Group Practice PAC ID
2961464169
Professional Enrollment ID
I20191118001673
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience36
Completeness75
Years active:6State licenses:1Digital endpointsOther names

1,865 PHYSICAL THERAPIST IN PRIVATE PRACTICE in IN

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Provider Addresses for EMANUEL LUCIAN BOAR (PT)

  • 4106 MERCHANT RD RM A

    FORT WAYNE, IN 468181248

    Phone: (260) 255-6494

    Fax: (260) 399-2075

    Type: Mailing

  • 4106, Merchant Road, Fort Wayne, Allen County, Indiana, 46818, United States

    RM A

    FORT WAYNE, IN 468181248

    Phone: (260) 255-6494

    Fax: (260) 399-2075

    Type: Location

  • 3630 ILLINOIS RD

    FORT WAYNE, IN 468042062

    Phone: (260) 255-6494

    Fax: (260) 399-2075

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-11-18

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20191118001673IPhysical Therapist In Private PracticeINTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97112Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes88611$0
97530Therapy procedure using functional activities76211$0
View full utilization report →

Insurance plans in this area (ZIP 46818)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 2961464169View full group profile
NameSpecialtyState
-IN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
Physical Therapist In Private PracticeIN
-IN

Reviews

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Frequently asked questions

Is there an official ID for EMANUEL LUCIAN BOAR (PT) in U.S. healthcare records?
The official identifier for EMANUEL LUCIAN BOAR (PT) is NPI 1972165272.
Is EMANUEL LUCIAN BOAR (PT) shown as active in public data?
Registry records indicate EMANUEL LUCIAN BOAR (PT) maintains an active NPI.
How would a patient describe EMANUEL LUCIAN BOAR (PT)'s focus?
For EMANUEL LUCIAN BOAR (PT), the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
Is EMANUEL LUCIAN BOAR (PT) associated with Fort Wayne?
Public fields place EMANUEL LUCIAN BOAR (PT) around Fort Wayne, Indiana. Always confirm the exact site before visiting.
Can I trust this NPI listing for EMANUEL LUCIAN BOAR (PT)?
The listing is sourced from the national NPI registry. If something looks off, compare with NPPES and the clinic's website.

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