Carola E Bosenberg, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

26274 Issued in WA

Practice address

1611 116TH Ave NE
Suite 218
Bellevue, WA 98004-3045

Phone

(425) 454-3100

Fax

(425) 454-3101

NPI assigned

Jan 24, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1871648204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1611 116TH AVE NE",
            "address_2": "SUITE 218",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043045",
            "telephone_number": "425-454-3100",
            "fax_number": "425-454-3101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1611 116TH AVE NE",
            "address_2": "SUITE 218",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980043045",
            "telephone_number": "425-454-3100",
            "fax_number": "425-454-3101"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSENBERG",
        "first_name": "CAROLA",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-24",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "26274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "202124",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "00547255",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "REGENCE BLUE SHIELD",
            "identifier": "1610BO",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lila Katrese Borlaza
• Elena Borodyansky, D.D.S.
• Galina Borodyansky, D.D.S.
• Faisal Bosaid
• Amy Bosch
• Jara B Bosmans
• Boston Medical Group- Washington, P.C.
• James E Boswell, M.D.
• Michael Vasile Bota, M.D.
• Mariam Boulos, PH

• Child & Adolescent Psychiatry Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Child & Adolescent Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.