Gretchen Bosacker, M.D.
Individual provider Active NPI Family Medicine Physician · Wyoming, MN
NPI 1679532147 · NPPES record last updated Jun 22, 2011
Key facts
- NPI
- 1679532147
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 48016 (MN)
- Practice address
- 5200 Fairview Blvd
Wyoming, MN 55092-8013 - Phone
- (651) 982-7000
- NPI assigned
- Mar 22, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Family Practice
- Education
- Medical University of South Carolina College of Medicine, 1998
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Legacy Urgent Care PA
Practice addresses (Care Compare)
9205 Legacy Dr
Frisco, TX 75033-6750
Phone (972) 625-6020
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20251210004034 | TX | Practitioner - Family Practice | 1355366048 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Frisco Emergency Medicine Associates, PA | Current |
Accepting new patients | |
| Legacy Urgent Care, PA | Current |
Accepting new patients |
Locations
330 S Denton Tap Rd
Coppell, TX 75019
Phone (469) 312-7777
9205 Legacy Dr
Frisco, TX 75033
Phone (972) 625-6020
2810 S Hardin Blvd
Ste 100
McKinney, TX 75072
Phone (972) 548-7277
8950 N Tarrant Pkwy
North Richlnd Hls, TX 76182
Phone (817) 281-7277
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | 48016 | MN | Yes |
Addresses
Primary practice location
5200 Fairview Blvd
Wyoming, MN 55092-8013
Mailing address
400 Robert St N
Saint Paul, MN 55101-2098
Phone (651) 665-3221
Other providers in Wyoming, MN
- Anita Bajpai
- Kaitlin Barabash
- Kaylana Bell
- Lee Ann Bera
- Borealis Dental Wyoming PA
- Faith Bouttell
- Nissa K Brekke
- Kevin Anthony Brueske
- Jessica Lee Tomlin Brunfelt
- Judy A Buda
All providers in Wyoming, MN · Family Medicine Physician in Minnesota
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 22, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.