Peter William Bossart, MD

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

181676-1205 Issued in UT

Practice address

1250 E 3900 S Ste 320
Salt Lake City, UT 84124-1350

Phone

(801) 263-1621

Fax

(801) 906-0556

NPI assigned

Oct 3, 2006

Sex

Male

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 UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641772800000",
    "number": "1477647246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 320",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241350",
            "telephone_number": "801-263-1621",
            "fax_number": "801-906-0556"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 E 3900 S STE 320",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241350",
            "telephone_number": "801-263-1621",
            "fax_number": "801-906-0556"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSART",
        "first_name": "PETER",
        "middle_name": "WILLIAM",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2022-01-10",
        "certification_date": "2022-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "UT",
            "license": "181676-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark E Boschert, M.D.
• J. Jerald Boseman, D.D.S.
• Jody Boseman, DDS
• Jordan Cody Boseman, DDS
• Bosey Dental Enterprises PLLC
• Philip J Bossart, MD
• Steven Colter Bossman
• Jonathan Boster, O.D.
• Randy Earl Bostwick
• Ra'Chelle Boswell-Collins

• Colon & Rectal Surgery Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Colon & Rectal Surgery Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 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.