Samantha Ruth Bossak

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN209672 Issued in GA

Practice address

4B Skidaway Village Walk
Savannah, GA 31411-3141

Phone

(912) 598-6322

Fax

(912) 809-4995

NPI assigned

Feb 18, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/26549/brand/1/csg/1/fhir/r4
• Direct secure messaging: samantha.bossak.1@26549.direct.athenahealth.com

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.

• Coastal Care MD, LLC

  • Family Medicine Physician
  • Savannah, GA
  • NPI 1881200772
  NPD
• Coastal Care Management Services LLC

  • Internal Medicine Physician
  • Savannah, GA
  • NPI 1710869250
  NPD (past)
• Kelsey Alexander MD, LLC

  • Pediatrics Physician
  • Savannah, GA
  • NPI 1891420311
  NPD (past)

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

{
    "created_epoch": "1645142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645142400000",
    "number": "1245985209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 13686",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314160686",
            "telephone_number": "912-600-1137",
            "fax_number": "912-806-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4B SKIDAWAY VILLAGE WALK",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314113141",
            "telephone_number": "912-598-6322",
            "fax_number": "912-809-4995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSAK",
        "first_name": "SAMANTHA",
        "middle_name": "RUTH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-18",
        "last_updated": "2022-02-18",
        "certification_date": "2022-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN209672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Boring, MD
• Ortelio Bosch, MD
• Madison Marie Bosilevac, M.S., CCC-SLP
• Robert Alexander Bosque Jr., DMD
• Michael A. Bossak, MD
• Bryce Bossinger
• Jason Bostic
• Jane Bostwick, AA-C
• William Carson Boswell, MD
• Randy Kyle Bottner, MD

• Family Nurse Practitioner in Savannah, GA
• Providers in Savannah, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 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.