Individual provider Active NPI

Paula Bossert

  • Clinical Social Worker
  • Sisseton, SD
National Provider Identifier
1437558822
Registry record updated Sep 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
3722 Issued in ND
Practice address
100 Lake Traverse Dr
Sisseton, SD 57262-7046
Phone
(605) 698-7606
NPI assigned
Aug 21, 2014
Last updated
Sep 25, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 3722 ND Primary

Addresses

Primary practice location

100 Lake Traverse Dr
Sisseton, SD 57262-7046

Mailing address

100 Lake Traverse Dr
Sisseton, SD 57262-7046
Phone (605) 698-7606

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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

Enrollment IDStateProvider typePAC IDDetails
I20140922001973 TX Practitioner - Clinical Social Worker 8729207857 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Woodrow Wilson Keeble Memorial Health Care CenterGroup PAC ID 1850295940, 23 clinicians

Practice addresses (Care Compare)

100 Lake Traverse Dr
Sisseton, SD 57262-7046
Phone (605) 698-7606

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3722NDMDOphthalmology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Woodrow Wilson Keeble Memorial Health Care Center CurrentSince Aug 21, 2014 Accepting new patients

Locations

100 Lake Traverse Dr
Sisseton, SD 57262

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": "1408579200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569369600000",
    "number": "1437558822",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 LAKE TRAVERSE DR",
            "city": "SISSETON",
            "state": "SD",
            "postal_code": "572627046",
            "telephone_number": "605-698-7606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 LAKE TRAVERSE DR",
            "city": "SISSETON",
            "state": "SD",
            "postal_code": "572627046",
            "telephone_number": "605-698-7606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSERT",
        "first_name": "PAULA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-21",
        "last_updated": "2019-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ND",
            "license": "3722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sisseton, SD

Sources for this page

Verify at the official NPI Registry.