Individual provider Active NPI

Rachael C Boswell

  • Medical Physician Assistant
  • Ocean City, MD
National Provider Identifier
1093278038
Registry record updated Apr 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
C007167 Issued in MD
Practice address
12547 Ocean Gtwy
Ocean City, MD 21842-9689
Phone
(410) 213-0119
Fax
(410) 213-2875
NPI assigned
Apr 8, 2019
Last updated
Apr 8, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X C007167 MD Primary

Addresses

Primary practice location

12547 Ocean Gtwy
Ocean City, MD 21842-9689

Mailing address

12547 Ocean Gtwy
Ocean City, MD 21842-9689
Phone (410) 213-0119

Other identifiers 1

IdentifierTypeStateIssuer
C0007167OtherMDMEDICAL LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221005000298 TN Practitioner - Physician Assistant 7810239571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
DX Mso PLLCGroup PAC ID 7719131101, 88 clinicians

Practice addresses (Care Compare)

170 Mouse Creek Rd NW
Cleveland, TN 37312-3840
Phone (423) 458-1426

306 Cherokee Blvd
Suite 108
Chattanooga, TN 37405-3811
Phone (423) 259-5997

9058 Old Lee Hwy
Ooltewah, TN 37363-5631
Phone (423) 458-1426

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5150TNMDSpeech-Language Pathologist
C007167MDMDMedical Physician Assistant

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1093278038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12547 OCEAN GTWY",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218429689",
            "telephone_number": "410-213-0119",
            "fax_number": "410-213-2875"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12547 OCEAN GTWY",
            "city": "OCEAN CITY",
            "state": "MD",
            "postal_code": "218429689",
            "telephone_number": "410-213-0119",
            "fax_number": "410-213-2875"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSWELL",
        "first_name": "RACHAEL",
        "middle_name": "C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-08",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "MD",
            "license": "C007167",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAL LICENSE",
            "identifier": "C0007167",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocean City, MD

Sources for this page

Verify at the official NPI Registry.