Individual provider Active NPI

Hemmo Alexander Bosscher, M.D.

  • Interventional Pain Medicine Physician
  • Lubbock, TX
National Provider Identifier
1780687517
Registry record updated Nov 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Interventional Pain Medicine PhysicianTaxonomy code 208VP0014X
License
K3995 Issued in TX
Practice address
4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520
Phone
(806) 744-7223
Fax
(806) 740-3325
NPI assigned
May 24, 2005
Last updated
Nov 14, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine Physician 208VP0014X K3995 TX Primary

Addresses

Primary practice location

4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520

Mailing address

4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520
Phone (806) 744-7223

Other practice location 1

3505 22nd Pl
Lubbock, TX 79410-1315
Phone (806) 785-5700

Other identifiers 3

IdentifierTypeStateIssuer
170407401MedicaidTX
108933105OtherTXFIRSTCARE PROVIDER #
8M7921OtherTXBLUE CROSS BLUE SHIELD

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address hbosscher1380001@oc.providencedirect.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20040622000252 TX Practitioner - Interventional Pain ManagementPractitioner - Anesthesiology 7911982319 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Interventional Pain ManagementAlso: Anesthesiology
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Grace Clinic of LubbockGroup PAC ID 5597768101, 44 clinicians

Practice addresses (Care Compare)

4515 Marsha Sharp Fwy
Lubbock, TX 79407-2520
Phone (806) 744-7223

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23476TXMDDental Hygienist

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Clinic of Lubbock CurrentSince Sep 1, 2014 Accepting new patients
Grace Clinic of Lubbock Interventional Pain Medicine CurrentSince Sep 1, 2014 Accepting new patients

Locations

2804 N Loop 289
Lubbock, TX 79415
Phone (806) 740-3363

3505 22nd Pl
Lubbock, TX 79410
Phone (806) 785-5700

4515 Marsha Sharp Fwy
Lubbock, TX 79407
Phone 80674472232432

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

Interoperability endpoints

  • Direct secure messaging: hboss@yourcarecommunity.org
  • Direct secure messaging: hbosscher1380001@oc.providencedirect.org
  • Direct secure messaging: hemmo.bosscher@direct.myteamcare.com

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, 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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731542400000",
    "number": "1780687517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4515 MARSHA SHARP FWY",
            "city": "LUBBOCK",
            "state": "TX",
            "postal_code": "794072520",
            "telephone_number": "806-744-7223",
            "fax_number": "806-740-3325"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3505 22nd Pl",
            "address_purpose": "LOCATION",
            "city": "Lubbock",
            "state": "TX",
            "postal_code": "794101315",
            "country_code": "US",
            "telephone_number": "806-785-5700",
            "fax_number": "806-516-5383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSSCHER",
        "first_name": "HEMMO",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2024-11-14",
        "certification_date": "2024-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": "TX",
            "license": "K3995",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "170407401",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRSTCARE PROVIDER #",
            "identifier": "108933105",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8M7921",
            "state": "TX"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "hbosscher1380001@oc.providencedirect.org",
            "affiliation": "N",
            "address_1": "3505 22nd Pl",
            "city": "Lubbock",
            "state": "TX",
            "country_code": "US",
            "postal_code": "794101315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lubbock, TX

Sources for this page

Verify at the official NPI Registry.