Jay W Bosco, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901002847 Issued in MI

Practice address

1480 W Center Rd
Ste 14
Essexville, MI 48732-2143

Phone

(989) 892-5555

Fax

(989) 892-9525

NPI assigned

Jun 10, 2005

Last updated

Dec 26, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1118361600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1230249600000",
    "number": "1649274101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 W CENTER RD",
            "address_2": "STE 14",
            "city": "ESSEXVILLE",
            "state": "MI",
            "postal_code": "487322143",
            "telephone_number": "989-892-5555",
            "fax_number": "989-892-9525"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 W CENTER RD",
            "address_2": "STE 14",
            "city": "ESSEXVILLE",
            "state": "MI",
            "postal_code": "487322143",
            "telephone_number": "989-892-5555",
            "fax_number": "989-892-9525"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSCO",
        "first_name": "JAY",
        "middle_name": "W",
        "credential": "OD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-06-10",
        "last_updated": "2008-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901002847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "944445853",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "94-4445853",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Lee Berkobien, BSW
• Lauren Christina Beyerlein, RPH
• Bio-Medical Applications of Michigan, Inc. (Bay Area Regional Dialysis Center - Bay City)
• Kaitlyn Rose Blackmer
• Monica Borsenik
• Terra Jo Bowker
• Chelsea Boykov
• Steven Brennan, DO
• Riley Grace Brewer
• Jennifer Marie Brown, LMT

• Optometrist in Essexville, MI
• Providers in Essexville, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2008; 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.