Olatunde Bosu

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

A177863 Issued in CA

Practice address

39407 Vista del Sol
Rancho Mirage, CA 92270-3283

Phone

(760) 773-4130

Fax

(607) 773-1374

NPI assigned

Jul 1, 2014

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 PA, CA2 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 2

Specialty

Family Practice

Education

Yale University School of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Desert Medical Group IncGroup PAC ID 8123930427, 71 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/GBBBDD/Endpoint/GBBBDD
• Direct secure messaging: olatunde.bosu.p5@direct.mydohc.nextgenshare.com
• Direct secure messaging: olatunde.bosu.p2@direct.mydohc.nextgenshare.com

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.

• Desert Medical Group, Inc.

  • Family Medicine Physician
  • Palm Springs, CA
  • NPI 1114918612
  Medicare reassignment Care Compare group NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Danville, PA
  • NPI 1366493868
  Medicare reassignment NPD
• Geisinger Clinic

  • Diagnostic Radiology Physician
  • Danville, PA
  • NPI 1558313023
  NPD
• Geisinger Clinic

  • Family Medicine Physician
  • Honesdale, PA
  • NPI 1720495393
  NPD
• Clinica Medica Familiar-PHN Inc

  • Family Medicine Physician
  • Fontana, CA
  • NPI 1568585024
  NPD (past)

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1676851200000",
    "number": "1588070346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "39407 VISTA DEL SOL",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703283",
            "telephone_number": "760-773-4130",
            "fax_number": "760-773-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "39407 VISTA DEL SOL",
            "city": "RANCHO MIRAGE",
            "state": "CA",
            "postal_code": "922703283",
            "telephone_number": "760-773-4130",
            "fax_number": "607-773-1374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "100 North Academy Ave",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "PA",
            "postal_code": "17822",
            "country_code": "US",
            "telephone_number": "570-214-5681",
            "fax_number": "570-271-6578",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "405 Belcher St",
            "address_purpose": "LOCATION",
            "city": "Centreville",
            "state": "AL",
            "postal_code": "350422946",
            "country_code": "US",
            "telephone_number": "205-926-2992 x7690",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSU",
        "first_name": "OLATUNDE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-01",
        "last_updated": "2023-02-20",
        "certification_date": "2023-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD462235",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "CA",
            "license": "A177863",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Bornstein, NP
• Harold Stephan Bornstein, MD
• Amanda Marie Bosley, CRNA
• Jacob R Bosley, MD
• Burton Boss, MT
• Christopher Botros
• Allison James Botwin, M.D.
• Richard John Bowdle, MD
• Laura Boyer
• Seyed Bozorgi

• Addiction Medicine (Family Medicine) Physician in Rancho Mirage, CA
• Providers in Rancho Mirage, CA by specialty
• Addiction Medicine (Family Medicine) Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2023; 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.
• 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.