Individual provider Active NPI

Daniel Geoffrey Bosso, DO

  • Family Medicine Physician
  • Gainesville, GA
National Provider Identifier
1699815225
Registry record updated Feb 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
066761 Issued in GA
Practice address
597 S Enota Dr NE
Gainesville, GA 30501-2545
Phone
(770) 219-8102
Fax
(770) 219-7778
NPI assigned
Feb 6, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 36654 MO
Family Medicine Physician 207Q00000X 066761 GA Primary

Addresses

Primary practice location

597 S Enota Dr NE
Gainesville, GA 30501-2545

Mailing address

601 S Enota Dr NE
Suite Q
Gainesville, GA 30501-2400
Phone (770) 219-7826

Other identifiers 2

IdentifierTypeStateIssuer
98641OtherMOAR BLUE SHIELD #
247970015MedicaidMO

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address dbosso29396@nghs.gadirect.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120224000806 GA Practitioner - Emergency Medicine 8325172513 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
88.16 of 100Reported as group
Quality
85.71
Promoting interoperability
100
Improvement activities
40
Cost
74.81

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Georgia Physicians Group Inc Emergency Medicine CurrentSince Aug 1, 2021 Accepting new patients
Northeast Georgia Medical Center, Inc. PastSince Aug 1, 2021 Accepting new patients

Locations

1515 River Pl
Ste 100
Braselton, GA 30517
Phone (770) 848-6195

4445 S Lee St
Ste 100
Buford, GA 30518
Phone (770) 848-5200

597 S Enota Dr NE
Gainesville, GA 30501
Phone (770) 219-8275

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.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1699815225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 S ENOTA DR NE",
            "address_2": "SUITE Q",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012400",
            "telephone_number": "770-219-7826"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "597 S ENOTA DR NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305012545",
            "telephone_number": "770-219-8102",
            "fax_number": "770-219-7778"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSO",
        "first_name": "DANIEL",
        "middle_name": "GEOFFREY",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-06",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MO",
            "license": "36654",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "066761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AR BLUE SHIELD #",
            "identifier": "98641",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "247970015",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dbosso29396@nghs.gadirect.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "597 S Enota Dr NE",
            "city": "Gainesville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "305012545",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.