Michael A. Bossak, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

066457 Issued in GA

Practice address

4700 Waters Ave
Savannah, GA 31404

Phone

(912) 350-8180

Fax

(912) 350-8427

NPI assigned

Jun 11, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Pedsnow LLC

  dba PedsNow

  • Pediatric Adolescent Medicine Physician
  • Hinesville, GA
  • NPI 1427616515
  Medicare reassignment NPD
• Savannah Pediatric Care, LLC

  • Pediatrics Physician
  • Savannah, GA
  • NPI 1124532817
  Medicare reassignment NPD
• Pedsnow LLC

  dba PedsNow Pooler, LLC

  • Pediatric Adolescent Medicine Physician
  • Pooler, GA
  • NPI 1255012753
  NPD
• Savannah Health Services, LLC

  dba Memorial Health University Medical Center

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1053824292
  NPD (past)

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

{
    "created_epoch": "1213142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533600000000",
    "number": "1740440916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314046220",
            "telephone_number": "912-350-8180",
            "fax_number": "912-350-8427"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4700 WATERS AVE",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "31404",
            "telephone_number": "912-350-8180",
            "fax_number": "912-350-8427"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSAK",
        "first_name": "MICHAEL",
        "middle_name": "A.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-06-11",
        "last_updated": "2018-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "GA",
            "license": "066457",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00955092",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003111162A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01457468",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "624791",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GA1236",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nicholas Borchardt, DC
• Michael Boring, MD
• Ortelio Bosch, MD
• Madison Marie Bosilevac, M.S., CCC-SLP
• Robert Alexander Bosque Jr., DMD
• Samantha Ruth Bossak
• Bryce Bossinger
• Jason Bostic
• Jane Bostwick, AA-C
• William Carson Boswell, MD

• Pediatrics Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Pediatrics Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.