Individual provider Active NPI

Jodi L Bosak, MD

  • Anesthesiology Physician
  • Orlando, FL
National Provider Identifier
1679791875
Registry record updated Aug 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
ME110241 Issued in FL
Practice address
83 W Miller St
Orlando, FL 32806-2031
Phone
(321) 843-2584
Fax
(352) 265-6922
NPI assigned
Apr 23, 2007
Last updated
Aug 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X ME110241 FL Primary
Anesthesiology Physician 207L00000X MT188050 PA

Addresses

Primary practice location

83 W Miller St
Orlando, FL 32806-2031

Mailing address

1613 N. Harrison Parkway
Suite 200, Mailstop SH-9a
Sunrise, FL 33323-2896
Phone (954) 838-2371

Other identifiers 1

IdentifierTypeStateIssuer
003763000MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20110829000607 FL Practitioner - Anesthesiology 4880864909 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Pennsylvania State University College of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
US Anesthesia Partners of Florida IncGroup PAC ID 0345143152, 1,111 clinicians

Practice addresses (Care Compare)

17000 Porter Rd
Winter Garden, FL 34787-8915
Phone (954) 939-5000

2000 Fowler Grove Blvd
Winter Garden, FL 34787-5050
Phone (407) 614-0500

400 Celebration PL
Celebration, FL 34747-4970
Phone (407) 764-4000

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-5600

83 W Miller St
Orlando, FL 32806-2031
Phone (954) 939-5000

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME110241FLMDAnesthesiology Physician
MT188050PAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiologists of Greater Orlando Inc Anesthesiology CurrentSince Aug 1, 2012 Accepting new patients
Anesthesiologists of Greater Orlando Inc Anesthesiology CurrentSince Aug 1, 2012 Accepting new patients

Locations

380 Rinehart Rd
Lake Mary, FL 32746
Phone (321) 842-0550

555 W State Road 434
Longwood, FL 32750
Phone (407) 767-1200

10000 W Colonial Dr
Ocoee, FL 34761
Phone (321) 843-1378

1405 S Orange Ave
Ste 400
Orlando, FL 32806
Phone (407) 426-8331

22 Underwood St
Orlando, FL 32806
Phone (321) 841-6263

45 W Crystal Lake St
Ste 300
Orlando, FL 32806
Phone (407) 254-2526

52 Underwood St
Orlando, FL 32806
Phone (321) 841-3581

7477 Sandlake Commons Blvd
Orlando, FL 32819
Phone (407) 264-9633

83 W Miller St
Orlando, FL 32806
Phone (321) 841-5281

9400 Turkey Lake Rd
Orlando, FL 32819
Phone (321) 843-5500

2906 17th St
Saint Cloud, FL 34769
Phone (407) 425-4847

17000 Porter Rd
Winter Garden, FL 34787
Phone (321) 841-3467

Networks

  • Optimum HealthCare HMO Network

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470614400000",
    "number": "1679791875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1613 N. HARRISON PARKWAY",
            "address_2": "SUITE 200, MAILSTOP SH-9A",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232896",
            "telephone_number": "954-838-2371",
            "fax_number": "954-851-1746"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 W MILLER ST",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328062031",
            "telephone_number": "321-843-2584",
            "fax_number": "352-265-6922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSAK",
        "first_name": "JODI",
        "middle_name": "L",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-23",
        "last_updated": "2016-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "FL",
            "license": "ME110241",
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "PA",
            "license": "MT188050",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003763000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.