Individual provider Active NPI

Chris Boseovski, MD

  • General Practice Physician
  • Auburn, CA
National Provider Identifier
1508940107
Registry record updated Oct 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
73063 Issued in CA
Practice address
11961 Heritage Oak PL
Auburn, CA 95603-2461
Phone
(530) 823-1100
NPI assigned
Oct 24, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 0101276912 VA
General Practice Physician 208D00000X 73063 CA Primary
Dentist 122300000X D15051 CA
Dentist 122300000X 56189 CA

Addresses

Primary practice location

11961 Heritage Oak PL
Auburn, CA 95603-2461

Mailing address

5212 Piedmont Dr
Santa Rosa, CA 95409-2846
Phone (707) 494-2802

Other practice location 1

550 E Washington Blvd
Crescent City, CA 95531-8160
Phone (707) 465-4636

Other practice location 2

5212 Piedmont Dr
Santa Rosa, CA 95409-2846
Phone (707) 494-2802

Other practice location 3

100 Oak Ave SW
Montgomery, MN 56069-1243
Phone (707) 494-2802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN, DC, CA4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20230518000349 MN Practitioner - General Practice 2264827914
I20230810004413 DC Practitioner - General Practice 2264827914
I20240321003305 CA Practitioner - Dentist 2264827914 Reassigns benefits to 1 organization
I20250307001627 MN Practitioner - Dentist 2264827914

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D15051CAMDDentist
73063CAMDGeneral Practice Physician
0101276912VAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Clinicas del Camino Real Inc CurrentSince Mar 11, 2024 Accepting new patients
Clinicas del Camino Real Inc Current Accepting new patients
Clinicas del Camino Real Inc CurrentSince Mar 11, 2024 Accepting new patients
Dr Chris Boseovski DMD LLC General Practice Past Accepting new patients

Locations

355 Central Ave
Fillmore, CA 93015
Phone (805) 524-4926

500 E Main St
Santa Paula, CA 93060
Phone (805) 933-0895

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761696000000",
    "number": "1508940107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5212 PIEDMONT DR",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954092846",
            "telephone_number": "707-494-2802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11961 HERITAGE OAK PL",
            "city": "AUBURN",
            "state": "CA",
            "postal_code": "956032461",
            "telephone_number": "530-823-1100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 E Washington Blvd",
            "address_purpose": "LOCATION",
            "city": "Crescent City",
            "state": "CA",
            "postal_code": "955318160",
            "country_code": "US",
            "telephone_number": "707-465-4636",
            "fax_number": "707-387-9808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5212 Piedmont Dr",
            "address_purpose": "LOCATION",
            "city": "Santa Rosa",
            "state": "CA",
            "postal_code": "954092846",
            "country_code": "US",
            "telephone_number": "707-494-2802",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Oak Ave SW",
            "address_purpose": "LOCATION",
            "city": "Montgomery",
            "state": "MN",
            "postal_code": "560691243",
            "country_code": "US",
            "telephone_number": "707-494-2802",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSEOVSKI",
        "first_name": "CHRIS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-24",
        "last_updated": "2025-10-29",
        "certification_date": "2025-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "VA",
            "license": "0101276912",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "73063",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "D15051",
            "primary": false
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "CA",
            "license": "56189",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Auburn, CA

Sources for this page

Verify at the official NPI Registry.