Justin James Boseck, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

Practice address

3401 45TH St S Ste a
Fargo, ND 58104-8970

Phone

(701) 356-4384

Fax

(701) 356-4383

NPI assigned

Mar 2, 2010

Sex

Male

Sole proprietor

Yes

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.

• Benson Psychological Services PC

  • Community/Behavioral Health Agency
  • Fargo, ND
  • NPI 1477709574

  ND

  Medicare reassignment NPD
• Integrated Intervention Specialists, LLC

  • Community/Behavioral Health Agency
  • Fargo, ND
  • NPI 1275194136

  ND

  Medicare reassignment NPD
• PSJ Acquisition LLC

  • Psychiatric Hospital
  • Fargo, ND
  • NPI 1679709802

  ND

  Medicare reassignment
• PSJ Acquisition LLC

  • Psychologist
  • Fargo, ND
  • NPI 1720454267
  NPD

Medicare fee-for-service enrollment

Enrolled in ND

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

Practice roles

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 21, 2022.

{
    "created_epoch": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1083937270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3060 FRONTIER WAY SOUTH",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "58103",
            "telephone_number": "701-232-2340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3401 45TH ST S STE A",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581048970",
            "telephone_number": "701-356-4384",
            "fax_number": "701-356-4383"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3060 Frontier Way South",
            "address_purpose": "LOCATION",
            "city": "Fargo",
            "state": "ND",
            "postal_code": "58103",
            "country_code": "US",
            "telephone_number": "701-232-2340",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSECK",
        "first_name": "JUSTIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-03-02",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Morgan Margaret Borud, NP-C
• Corey David Bos, APRN, CRNA
• Tricia Jo Bosak-Bovkoon, CTRS
• Jessica L Bosch, RN
• Ryan T Bosch
• Suzanne Marie Boseck, OTR/L
• Donna Bosh
• Morgan Christine Bosley, LAC, LADC
• Beverly Bosman, OTR/L
• Rosalyn Bossany

• All providers in Fargo, ND
• Psychologist in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.