Marybeth Bossolini

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

338889 Issued in NY

Practice address

101 Jordan Rd
Suite 200
Troy, NY 12180-8309

Phone

(518) 274-0476

Fax

(518) 274-0497

NPI assigned

Jun 24, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2014

Medicare assignment

May accept Medicare assignment

Group practices

W Bruce Clark MD PCGroup PAC ID 6608839162, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Peter'S Hospital Hospital, Albany, NY, CCN 330057

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbossolini@wbruceclarkmdpc.medentdirect.com
• Direct secure messaging: marybeth.bossolini@troypediatrics.chartmakerdirect.com

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.

• W Bruce Clark MD PC

  • Obstetrics & Gynecology Physician
  • Latham, NY
  • NPI 1396959110
  Medicare reassignment Care Compare group NPD
• Rensselaer County Bureau of Finance

  • Skilled Nursing Facility
  • Troy, NY
  • NPI 1225273485
  Medicare reassignment NPD
• St. Peter'S Health Partners Medical Associates, P.C.

  • Multi-Specialty Clinic/Center
  • Albany, NY
  • NPI 1750626834
  Medicare reassignment
• Rensselaer County Bureau of Finance

  • Mental Health Counselor
  • Troy, NY
  • NPI 1932130358
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• St. Peter'S Hospital of the City of Albany

  • General Acute Care Hospital
  • Albany, NY
  • NPI 1497701106
  Care Compare affiliation

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

{
    "created_epoch": "1403568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458604800000",
    "number": "1871908335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "711 TROY SCHENECTADY RD",
            "address_2": "SUITE 203",
            "city": "LATHAM",
            "state": "NY",
            "postal_code": "121102442",
            "telephone_number": "518-782-3700",
            "fax_number": "518-782-3799"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 JORDAN RD",
            "address_2": "SUITE 200",
            "city": "TROY",
            "state": "NY",
            "postal_code": "121808309",
            "telephone_number": "518-274-0476",
            "fax_number": "518-274-0497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSOLINI",
        "first_name": "MARYBETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-24",
        "last_updated": "2016-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "338889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Bombard, MS, ED.
• John Gerd Bonanno, PHARMD
• Kathleen Marie Bonnier, RPH
• Meghan Mary Bornt, OTR/L
• Robert Boska, MD
• Alexandra Boswell, LMSW
• Nicole Lynn Bouchey, PHARM D.
• Kiki Bourneuf, CNM
• Taylor Olivia Bouton, LMSW
• Emily Sue Bove

• Family Nurse Practitioner in Troy, NY
• Providers in Troy, NY by specialty
• Family Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 22, 2016; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.