Jacob Bosak, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2024010773 Issued in MO

Practice address

4029 Mill St
Kansas City, MO 64111-3008

Phone

(816) 285-0022

NPI assigned

Mar 13, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MO

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athletico LTDGroup PAC ID 4789602681, 2,187 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jacob.bosak.p9@direct.athleticoltd.nextgenshare.com

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.

• Athletico LTD

  dba Athletico Physical Therapy

  • Physical Therapist
  • Liberty, MO
  • NPI 1114449857
  Medicare reassignment Care Compare group NPD
• Athletico LTD

  dba Athletico Physical Therapy

  • Clinic/Center
  • Lafayette, IN
  • NPI 1053044867

  Physical Therapist

  NPD
• Athletico LTD

  dba Athletico Physical Therapy

  • Physical Therapist
  • Oak Brook, IL
  • NPI 1821085028
  NPD

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

{
    "created_epoch": "1710288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717113600000",
    "number": "1417716440",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4029 MILL ST",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113008",
            "telephone_number": "816-285-0022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSAK",
        "first_name": "JACOB",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-13",
        "last_updated": "2024-05-31",
        "certification_date": "2024-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "KS",
            "license": "11-07566",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2024010773",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Avery Grace Borron, RBT
• John J Borsa, MD
• Lyndsey Borton, MSN, APRN, FNP-C
• Adela J Bortone, MA,CCC-A
• Bos Transportation LLC
• Mary Ann Bosch
• Jahi Boseda, CRADC
• Lacey Boshe, MD
• Jeraldo Rico Bostic Sr.
• Samantha Bostick

• Physical Therapist in Kansas City, MO
• Providers in Kansas City, MO by specialty
• Physical Therapist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.