NPIMap

Organization Active NPI

Bosak Mischke Inc.

  • Counseling Psychologist
  • Saint Paul, MN
National Provider Identifier
1669733762
Registry record updated Jun 5, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Counseling PsychologistTaxonomy code 103TC1900X
License
LP2396 Issued in MN
Legal business name
BOSAK MISCHKE INC.
Practice address
821 Raymond Ave
#300
Saint Paul, MN 55114-1525
Phone
(651) 647-0659
Fax
(651) 646-1424
NPI assigned
Jun 5, 2012
Last updated
Jun 5, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2012

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

Authorized official

Name
John MischkeNPI 1912066952
Title
President
Phone
(651) 647-0659

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Counseling PsychologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 103TC1900X LP2396 MN Primary
Clinical Social WorkerGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 1041C0700X 4213 MN

Addresses

Primary practice location

821 Raymond Ave
#300
Saint Paul, MN 55114-1525

Mailing address

821 Raymond Ave
#300
Saint Paul, MN 55114-1525
Phone (651) 647-0659

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210505000728 MN Part B Supplier - Clinic/Group Practice 1951710821 Receives reassigned benefits from 1 practitioner
Practice locations: Saint Paul, MN

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1338854400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1669733762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "821 RAYMOND AVE",
            "address_2": "#300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141525",
            "telephone_number": "651-647-0659",
            "fax_number": "651-646-1424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 RAYMOND AVE",
            "address_2": "#300",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141525",
            "telephone_number": "651-647-0659",
            "fax_number": "651-646-1424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOSAK MISCHKE INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-05",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "MISCHKE",
        "authorized_official_first_name": "JOHN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "651-647-0659"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MN",
            "license": "LP2396",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "MN",
            "license": "4213",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Paul, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.