Individual provider Active NPI

Dillen J Bosgra, MD

  • Family Medicine Physician
  • North Dartmouth, MA
National Provider Identifier
1669966115
Registry record updated Oct 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
287147 Issued in MA
Practice address
500 Faunce Corner Rd
North Dartmouth, MA 02747-1278
Phone
(508) 973-2216
Fax
(508) 973-1305
NPI assigned
Jun 19, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 287147 MA Primary

Addresses

Primary practice location

500 Faunce Corner Rd
North Dartmouth, MA 02747-1278

Mailing address

200 Mill Rd
Fairhaven, MA 02719-5252
Phone (508) 973-2000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210806001872 MA Practitioner - Family Practice 8224432612 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southcoast Physicians Group Inc 875 clinicians

Practice addresses (Care Compare)

500 Faunce Corner Rd
North Dartmouth, MA 02747-1278
Phone (508) 973-2216

Hospital & facility affiliations

  • Southcoast Visiting Nurse Association Inc Home health agency, Fairhaven, MA, CCN 227101
  • Southcoast Hospitals Group Hospital, Fall River, MA, CCN 220074

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Southcoast Physicians Group, Inc. CurrentSince Jul 1, 2024 Accepting new patients
Southcoast Physicians Group, Inc. Family Medicine CurrentSince Jul 1, 2024 Accepting new patients

Locations

534 Prospect St
Fall River, MA 02720
Phone (508) 679-7766

386 Stanley St
Fall River, MA 02720
Phone (508) 324-3550

400 Stanley St
Fall River, MA 02720
Phone (508) 675-1054

500 Faunce Corner Rd
North Dartmouth, MA 02747
Phone (508) 973-2216

500 Faunce Corner Rd
Ste 170
North Dartmouth, MA 02747
Phone (508) 973-2216

Interoperability endpoints

  • Direct secure messaging: dbosgra72657@direct.southcoast.org

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.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1529366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729209600000",
    "number": "1669966115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 MILL RD",
            "city": "FAIRHAVEN",
            "state": "MA",
            "postal_code": "027195252",
            "telephone_number": "508-973-2000",
            "fax_number": "508-973-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 FAUNCE CORNER RD",
            "city": "NORTH DARTMOUTH",
            "state": "MA",
            "postal_code": "027471278",
            "telephone_number": "508-973-2216",
            "fax_number": "508-973-1305"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSGRA",
        "first_name": "DILLEN",
        "middle_name": "J",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-19",
        "last_updated": "2024-10-18",
        "certification_date": "2024-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MA",
            "license": "287147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Dartmouth, MA

Sources for this page

Verify at the official NPI Registry.