Individual provider Active NPI

Quinn M. Bosworth, DO

  • Family Medicine Physician
  • Okemos, MI
National Provider Identifier
1063440592
Registry record updated Mar 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
5101014014 Issued in MI
Practice address
1881 W Grand River Ave
Okemos, MI 48864-1840
Phone
(517) 339-2100
Fax
(517) 339-4620
NPI assigned
Jun 30, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 30, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 5101014014 MI Primary

Addresses

Primary practice location

1881 W Grand River Ave
Okemos, MI 48864-1840

Mailing address

1881 W Grand River Ave
Okemos, MI 48864-1840
Phone (517) 339-2100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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 1

Enrollment IDStateProvider typePAC IDDetails
I20040825000003 MI Practitioner - Family Practice 9234103292 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Michigan State University College of Osteopathic Medicine, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Grand River Family Care PCGroup PAC ID 8628304516, 2 clinicians

Practice addresses (Care Compare)

1881 W Grand River Ave
Okemos, MI 48864-1840

Hospital & facility affiliations

  • Elara Caring Home health agency, Jackson, MI, CCN 237274
  • Edward W Sparrow Hospital Hospital, Lansing, MI, CCN 230230
  • McLaren Greater Lansing Hospital, Lansing, MI, CCN 230167

Procedures performed for Medicare patients

ProcedureNumber of procedures
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy, Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Grand River Family Care, PC Family Medicine CurrentSince Sep 1, 2019 Accepting new patients
Redicare Partners PLLC Family Medicine PastSince Jun 18, 2011 Accepting new patients

Locations

1881 W Grand River Ave
Okemos, MI 48864
Phone (517) 339-2100

Interoperability endpoints

  • Direct secure messaging: quinn.bosworth.1@15091.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/15091/brand/3/csg/1/fhir/r4

Organizations & group practices 3

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

Hospital & facility affiliations 4

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

NPI Registry JSON

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

{
    "created_epoch": "1151625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427673600000",
    "number": "1063440592",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1881 W GRAND RIVER AVE",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641840",
            "telephone_number": "517-339-2100",
            "fax_number": "517-339-4620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1881 W GRAND RIVER AVE",
            "city": "OKEMOS",
            "state": "MI",
            "postal_code": "488641840",
            "telephone_number": "517-339-2100",
            "fax_number": "517-339-4620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSWORTH",
        "first_name": "QUINN",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-30",
        "last_updated": "2015-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "5101014014",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Okemos, MI

Sources for this page

Verify at the official NPI Registry.