Active NPI
Joseph S. Bosarge, PH.D
- Clinical Psychologist
- Austin, TX
National Provider Identifier
1508190505
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 34161
- Practice address
- 11238 Pinehurst Dr
Austin, TX 78747-1432 - Phone
- (512) 680-3013
- NPI assigned
- Sep 23, 2009
- 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 |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 34161 | TX | Primary |
Addresses
Primary practice location
11238 Pinehurst Dr
Austin, TX 78747-1432
Mailing address
2504 Rae Dell Ave
Austin, TX 78704-4735
Phone (512) 660-1853
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 34161 | TX | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deer Oaks Mental Health Associates PC | Clinical | Past | Accepting new patients |
| PM Management - Cedar Park NC LLC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
dba Cottonwood Creek Nursing and Rehabilitatioin Center
- Skilled Nursing Facility
- Cedar Park, TX
- NPI 1548527963
-
- Clinical Psychologist
- Las Cruces, NM
- NPI 1134175763
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1253664000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1474848000000",
"number": "1508190505",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2504 RAE DELL AVE",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787044735",
"telephone_number": "512-660-1853",
"fax_number": "855-700-9866"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11238 PINEHURST DR",
"city": "AUSTIN",
"state": "TX",
"postal_code": "787471432",
"telephone_number": "512-680-3013"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOSARGE",
"first_name": "JOSEPH",
"middle_name": "S.",
"name_prefix": "Dr.",
"credential": "PH.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2009-09-23",
"last_updated": "2016-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "TX",
"license": "34161",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Austin, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.