Individual provider Active NPI

Matej Bosnjak, FNP-BC

  • Family Nurse Practitioner
  • Knoxville, TN
National Provider Identifier
1962854968
Registry record updated Feb 25, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
APN21295 Issued in TN
Practice address
9320 Park West Blvd
Knoxville, TN 37923-4301
Phone
(865) 373-7100
Fax
(865) 374-2029
NPI assigned
Jul 1, 2016
Last updated
Feb 25, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 25, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 21295 TN
Family Nurse Practitioner 363LF0000X APN21295 TN Primary
Registered Nurse 163W00000X RN123498 TN

Addresses

Primary practice location

9320 Park West Blvd
Knoxville, TN 37923-4301

Mailing address

1515 Blackwood Dr
Knoxville, TN 37923-1102
Phone (423) 202-4415

Other identifiers 1

IdentifierTypeStateIssuer
Q022708MedicaidTN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address bosnjak.matej@covenanthealth.cernerdirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20160824001970 TN Practitioner - Nurse Practitioner 1951696343 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apple Healthcare Group PCGroup PAC ID 6103907605, 13 clinicians
Covenant Medical Group IncGroup PAC ID 2860305463, 363 clinicians
Southeastern Emergency Physicians LLCGroup PAC ID 2466364997, 776 clinicians

Practice addresses (Care Compare)

4307 Ball Camp Pike
Knoxville, TN 37921-3313
Phone (865) 524-1234

9320 Parkwest Blvd
Knoxville, TN 37923-4301
Phone (865) 373-7100

9352 Park W Blvd
Knoxville, TN 37923-4325
Phone (865) 373-1000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
85.88 of 100Reported as group
Quality
81.99
Promoting interoperability
100
Improvement activities
40
Cost
70.94

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RN123498TNMDRegistered Nurse
APN21295TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Southeastern Emergency Physicians LLC Nurse Practitioner CurrentSince Apr 1, 2025 Accepting new patients
Covenant Medical Group, Inc. CurrentSince Jan 13, 2025 Accepting new patients
Covenant Medical Group, Inc CurrentSince Jan 13, 2025 Accepting new patients
Cane Ridge Emergency Physicians LLC Past Accepting new patients

Locations

1643 NW 136th Ave
Ste 100
Sunrise, FL 33323
Phone (865) 500-1325

9320 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-7100

9352 Park West Blvd
Knoxville, TN 37923
Phone (865) 373-1000

Dept 888179
Knoxville, TN 37995

111 Clyde St
Loudon, TN 37774
Phone (865) 458-1554

990 Oak Ridge Tpke
Oak Ridge, TN 37830
Phone (865) 481-1000

200 Stonecrest Blvd
Smyrna, TN 37167
Phone (615) 768-2000

Interoperability endpoints

  • Direct secure messaging: matej.bosnjak.p1@direct.orthotn.nextgenshare.com

Organizations & group practices 5

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1467331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740441600000",
    "number": "1962854968",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 BLACKWOOD DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379231102",
            "telephone_number": "423-202-4415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9320 PARK WEST BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234301",
            "telephone_number": "865-373-7100",
            "fax_number": "865-374-2029"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSNJAK",
        "first_name": "MATEJ",
        "credential": "FNP-BC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-01",
        "last_updated": "2025-02-25",
        "certification_date": "2025-02-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "TN",
            "license": "21295",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TN",
            "license": "APN21295",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "TN",
            "license": "RN123498",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q022708",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bosnjak.matej@covenanthealth.cernerdirect.com",
            "affiliation": "N",
            "address_1": "9320 Park West Blvd",
            "city": "Knoxville",
            "state": "TN",
            "country_code": "US",
            "postal_code": "379234301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

Verify at the official NPI Registry.