Richard T Bosshardt, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

ME49691 Issued in FL

Practice address

1879 Nightingale LN
A-2
Tavares, FL 32778-4363

Phone

(352) 742-0079

Fax

(352) 742-0059

NPI assigned

Jul 11, 2006

Last updated

Jun 18, 2008By 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 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Plastic Surgery Center of Lake County, P.a.

  dba Bosshardt and Marzek , Plastic Surgery Associates

  • Plastic Surgery Physician
  • Tavares, FL
  • NPI 1790881654
  Medicare reassignment NPD

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213747200000",
    "number": "1942235783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1879 NIGHTINGALE LN",
            "address_2": "A-2",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784363",
            "telephone_number": "352-742-0079",
            "fax_number": "352-742-0059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1879 NIGHTINGALE LN",
            "address_2": "A-2",
            "city": "TAVARES",
            "state": "FL",
            "postal_code": "327784363",
            "telephone_number": "352-742-0079",
            "fax_number": "352-742-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSSHARDT",
        "first_name": "RICHARD",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2008-06-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "FL",
            "license": "ME49691",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "08371",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "035625500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dan Argin Boggus, MD
• Tamika S. Bolden
• Shalini Meera Boodram, MD
• Miguel J Boque-Santiago, MD
• Borys a Mascarenhas MD PA
• Brittney Bowen, CRNA
• Charles D. Bowers
• Elsie H Bowman, LCSW
• Brian Lee Boyd, PH.D.
• Jeffrey Gray Brabham, MD

• Plastic Surgery Physician in Tavares, FL
• Providers in Tavares, FL by specialty
• Plastic Surgery Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.