Mark O Bostrom, DO

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

38115 Issued in MN

Practice address

320 East Main Street
Crosby, MN 56441

Phone

(218) 546-7000

Fax

(218) 546-4400

NPI assigned

Oct 2, 2006

Last updated

Nov 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in MN

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

Specialty

Internal Medicine

Education

Rowan University School of Osteopathic Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cuyuna Regional Medical CenterGroup PAC ID 9537146550, shared by 3 NPIs, 133 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Cuyuna Regional Medical Center Hospital, Crosby, MN, CCN 241353

Merit-based Incentive Payment System (MIPS)

Final score

93.78 of 100Reported as apm

Quality

80.38

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mbostrom827871@direct.centracare.com

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.

• Cuyuna Regional Medical Center

  • Critical Access Hospital
  • Crosby, MN
  • NPI 1538143896
  Medicare reassignment NPD
• Cuyuna Regional Medical Center

  dba Longville Lakes Clinic

  • Family Medicine Physician
  • Longville, MN
  • NPI 1861414518
  Medicare reassignment NPD
• Advanced Integrative Medicine

  • General Practice Physician
  • Crosby, MN
  • NPI 1487949897
  NPD (past) Authorized official
• Cuyuna Regional Medical Center

  • Critical Access Hospital Clinic/Center
  • Crosby, MN
  • NPI 1639459282
  NPD
• Cuyuna Family Chiropractic

  • Chiropractor
  • Crosby, MN
  • NPI 1134397094
  NPD (past)

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

• Cuyuna Regional Medical Center

  • Critical Access Hospital
  • Crosby, MN
  • NPI 1538143896
  Care Compare affiliation

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1902990419",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "320 EAST MAIN STREET",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "56441",
            "telephone_number": "218-546-7000",
            "fax_number": "218-546-4400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "320 EAST MAIN STREET",
            "city": "CROSBY",
            "state": "MN",
            "postal_code": "56441",
            "telephone_number": "218-546-7000",
            "fax_number": "218-546-4400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTROM",
        "first_name": "MARK",
        "middle_name": "O",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-02",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "38115",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MN",
            "license": "38115",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "85419100",
            "state": "MN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbostrom155762@excellian.direct.allina.com",
            "affiliation": "Y",
            "affiliationName": "Cuyuna Regional Medical Center",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "mbostrom155762@excellian.direct.allina.com",
            "address_1": "320 E Main St",
            "city": "Crosby",
            "state": "MN",
            "country_code": "US",
            "postal_code": "564411645",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbostrom155762@excellian.direct.allina.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/PDF/TXT",
            "address_1": "320 E Main St",
            "city": "Crosby",
            "state": "MN",
            "country_code": "US",
            "postal_code": "564411645",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Rachelle Marie Beseman, PA-C, MPAS
• Rajesh Bhargava, MD
• Taylor Blom, PA-C
• Trenton Dean Blom
• Nicholas Boreen, PHARMD
• Lachelle Renee Brinks, FNP-BC
• Brianne Marie Burmeister, PHARM.D.
• Michael Timothy Cady, MD
• Rachel Sampson Cady, MD
• David Campbell, PT, DPT

• Internal Medicine Physician in Crosby, MN
• Providers in Crosby, MN by specialty
• Internal Medicine Physician in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2020; 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.