Melissa Sue Bosma, MD

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

4301095084 Issued in MI

Practice address

3707 New Vision Dr
Fort Wayne, IN 46845-1702

Phone

(260) 469-4763

NPI assigned

Jun 30, 2009

Last updated

Jan 27, 2016By the provider in NPPES

Sex

Female

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

Enrolled in MI, OH, IN3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Diagnostic Radiology

Education

University of Michigan Medical School, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Huron Valley Radiology PCGroup PAC ID 2961466859, 76 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
• Trinity Health Ann Arbor Hospital Hospital, Ann Arbor, MI, CCN 230156
• Trinity Health Livingston Hospital Hospital, Howell, MI, CCN 230069
• Chelsea Hospital Hospital, Chelsea, MI, CCN 230259
• St Joe Mercy Hospital System Livonia Hospital, Livonia, MI, CCN 230002

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbosma3286796@direct.trinity-health.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Huron Valley Radiology PC

  • Diagnostic Radiology Physician
  • Ypsilanti, MI
  • NPI 1659398519

  IN

  Medicare reassignment Care Compare group NPD
• Breast Diagnostic Center, LLC

  dba Breast Diagnostic Screening Center, LLC

  • Diagnostic Radiology Physician
  • Fort Wayne, IN
  • NPI 1790748499
  Medicare reassignment NPD
• Fort Wayne Radiology Associates LLC

  dba Dexa Diagnostics

  • Diagnostic Radiology Physician
  • Fort Wayne, IN
  • NPI 1063475861

  OH

  Medicare reassignment NPD
• X-Ray Consultants Inc

  • Diagnostic Radiology Physician
  • South Bend, IN
  • NPI 1770536815

  MI

  Medicare reassignment NPD
• Lansing Radiology Associates P C

  • Diagnostic Radiology Physician
  • Lansing, MI
  • NPI 1669425658
  Medicare reassignment NPD
• Summit Radiology P C

  • Diagnostic Radiology Physician
  • Fort Wayne, IN
  • NPI 1073584587
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Saint Joseph Mercy Livingston Hospital

  • General Acute Care Hospital
  • Brighton, MI
  • NPI 1093748642
  Care Compare affiliation
• St Joseph Mercy Chelsea Inc

  dba Chelsea Hospital

  • General Acute Care Hospital
  • Chelsea, MI
  • NPI 1992761985
  Care Compare affiliation
• St Joseph Mercy Hospital

  dba Trinity Heath Ann Arbor Hospital

  • General Acute Care Hospital
  • Ypsilanti, MI
  • NPI 1780658443
  Care Compare affiliation
• St Joseph Mercy Hospital-SMHC

  dba St Joseph Mercy Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation
• St Mary Mercy Hospital

  • General Acute Care Hospital
  • Livonia, MI
  • NPI 1790706901
  Care Compare affiliation

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

{
    "created_epoch": "1246320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453852800000",
    "number": "1053549956",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3707 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451702",
            "telephone_number": "260-469-4763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3707 NEW VISION DR",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468451702",
            "telephone_number": "260-469-4763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSMA",
        "first_name": "MELISSA",
        "middle_name": "SUE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-06-30",
        "last_updated": "2016-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "MI",
            "license": "4301095084",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MI",
            "license": "4301095084",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lisa Borton, MASSAGE THERAPIST
• Melissa Ann Borton
• Michaela Cristita Bosk
• Bosley Enterprises LLC
• Raphael Bosley, LMHC
• Samuel Thomas Boston, M.D.
• Benjamin Boswell, DDS
• Stacey M Boswell, PA
• Vaneska Bottino Da Costa, M.D.
• Sarah Botts, PT, DPT

• Diagnostic Radiology Physician in Fort Wayne, IN
• Providers in Fort Wayne, IN by specialty
• Diagnostic Radiology Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.