Elliott James Bosak

Primary specialty

Behavior TechnicianTaxonomy code 106S00000X

Practice address

427 West Travelers Trail, Burnsville MN, 55337
427 West Travelers Trail, Burnsville MN, 55337
Burnsville, MN 55337

Phone

(952) 247-2954

NPI assigned

Jan 6, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1033870696",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "427 WEST TRAVELERS TRAIL, BURNSVILLE MN, 55337",
            "address_2": "427 WEST TRAVELERS TRAIL, BURNSVILLE MN, 55337",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "55337",
            "telephone_number": "952-247-2954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "427 WEST TRAVELERS TRAIL, BURNSVILLE MN, 55337",
            "address_2": "427 WEST TRAVELERS TRAIL, BURNSVILLE MN, 55337",
            "city": "BURNSVILLE",
            "state": "MN",
            "postal_code": "55337",
            "telephone_number": "952-247-2954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSAK",
        "first_name": "ELLIOTT",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-09-15",
        "certification_date": "2022-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Bookhout, ATC
• Boost Learning Enrichment Programs, Inc.
• Erika Marie Bordwell
• Patricia Daly Borg, R.N.
• Cassidy Bos
• Kelli Denk Bosholm, PT
• Kelley Boylan
• Elizabeth N Boyum, PA
• Bradshaw Psycholgical Services
• David R Bradshaw, MED, LP

• Behavior Technician in Burnsville, MN
• Providers in Burnsville, MN by specialty
• Behavior Technician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.