Active NPI
Timothy Alan Bossetti, O.D.
- Optometrist
- El Paso, TX
National Provider Identifier
1407991912
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 3919
- Practice address
- 8401 Gateway Blvd W
El Paso, TX 79925-5657 - Phone
- (915) 775-4916
- Fax
- (915) 833-6404
- NPI assigned
- Feb 21, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optometrist | 152W00000X | 3919 | TX | Primary |
Addresses
Primary practice location
8401 Gateway Blvd W
El Paso, TX 79925-5657
Mailing address
10708 Chert St
El Paso, TX 79924-1647
Phone (915) 821-6835
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3919 | Other | TX | OPTOMETRY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3919 | TX | MD | Marriage & Family Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1172016000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1407991912",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "10708 CHERT ST",
"city": "EL PASO",
"state": "TX",
"postal_code": "799241647",
"telephone_number": "915-821-6835"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8401 GATEWAY BLVD W",
"city": "EL PASO",
"state": "TX",
"postal_code": "799255657",
"telephone_number": "915-775-4916",
"fax_number": "915-833-6404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSSETTI",
"first_name": "TIMOTHY",
"middle_name": "ALAN",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "TX",
"license": "3919",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OPTOMETRY",
"identifier": "3919",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in El Paso, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.