Theodore R Bosch, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD61652294 Issued in WA

Practice address

208 S 14TH St
Mount Vernon, WA 98274-4117

Phone

(360) 814-2600

NPI assigned

Feb 22, 2007

Sex

Male

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 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in AZ, MT, WA3 enrollments

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 3

Specialty

General Surgery

Education

University of Washington School of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pro Health One IncGroup PAC ID 2466778089, 27 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.44 of 100Reported as group

Quality

71.93

Promoting interoperability

100

Improvement activities

40

Cost

59.54

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: tbosch61991@skagit.direct-ci.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.

• Pro Health One Inc

  • Surgery Physician
  • Denver, CO
  • NPI 1053714584

  AZ, MT, WA

  Medicare reassignment Care Compare group NPD
• Public Hospital Dist No 1 Skagit

  • General Practice Physician
  • Mount Vernon, WA
  • NPI 1023332749
  Medicare reassignment NPD
• Signify Health, LLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1689158487

  AZ

  Medicare reassignment NPD
• Public Hospital Dist No 1 Skagit

  • Obstetrics & Gynecology Physician
  • Arlington, WA
  • NPI 1073554903
  NPD
• Public Hospital Dist No 1 Skagit

  • Physical Therapist
  • Mount Vernon, WA
  • NPI 1811460652
  NPD
• Public Hospital Dist No 1 Skagit

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • Mount Vernon, WA
  • NPI 1093889875
  NPD (past)
• Public Hospital Dist No 1 Skagit

  • Specialist
  • Mount Vernon, WA
  • NPI 1629012463
  NPD (past)
• Mineral King Surgical Associates, Inc.

  • Trauma Surgery Physician
  • Visalia, CA
  • NPI 1356587497
  NPD (past)

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787184000000",
    "number": "1912032962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1415 E KINCAID ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744126",
            "telephone_number": "360-428-2500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "208 S 14TH ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982744117",
            "telephone_number": "360-814-2600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1415 E Kincaid St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982744126",
            "country_code": "US",
            "telephone_number": "360-424-4111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "875 Wesley St Ste 210",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "WA",
            "postal_code": "982231668",
            "country_code": "US",
            "telephone_number": "360-659-4440",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOSCH",
        "first_name": "THEODORE",
        "middle_name": "R",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2026-08-20",
        "certification_date": "2026-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "WA",
            "license": "MD61652294",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2314374",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tbosch61991@skagit.direct-ci.com",
            "affiliation": "N",
            "endpointDescription": "Direct",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "208 S 14th St",
            "city": "Mount Vernon",
            "state": "WA",
            "country_code": "US",
            "postal_code": "982744117",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• John D Bond, MD
• Constance Marlene Bonner-Britt, LMHC
• Pasawat Boon-Yasidhi, MD
• Judith Ann Booth, LMP
• Patricia Born, MS
• Arika Boswell, MD
• Ruth C. Boswell, P.T.
• Cathrine Marie Bouma
• Melinda Buttles Bowen, M.A., CCC-SLP
• Kevin Roy Bowman, M.D.

• Surgery Physician in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2026; 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.