Roberta J. Bostian, AGACNP

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

12751401-4405 Issued in UT

Practice address

765 S Utah Ave
Idaho Falls, ID 83402-5093

Phone

(208) 525-2600

NPI assigned

Oct 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Corner Clinic St George LLCGroup PAC ID 6406241835, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St. George Regional Hospital Hospital, St George, UT, CCN 460021

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Corner Clinic St George LLC

  • Family Medicine Physician
  • St George, UT
  • NPI 1629568209
  Medicare reassignment Care Compare group NPD
• Santibanez Pac Utah

  • Geriatric Medicine (Internal Medicine) Physician
  • Salt Lake City, UT
  • NPI 1881469484
  Medicare reassignment NPD
• Utah Regional Hospitalists LLC

  • Hospitalist Physician
  • Murray, UT
  • NPI 1962821223
  Medicare reassignment NPD
• Utah Regional Hospitalists LLC

  • Hospitalist Physician
  • Idaho Falls, ID
  • NPI 1740715507
  NPD
• Corner Clinic Snow Canyon LLC

  • Family Medicine Physician
  • St George, UT
  • NPI 1952041048
  NPD (past)
• Enoch Community Healthcare

  • Family Medicine Physician
  • Enoch, UT
  • NPI 1659945343
  NPD (past)

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

• Ihc Health Services, Inc.

  • General Acute Care Hospital
  • St George, UT
  • NPI 1366452880
  Care Compare affiliation

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

{
    "created_epoch": "1633046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1972275501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2325 CORONADO ST",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834047407",
            "telephone_number": "208-557-2700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "765 S UTAH AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834025093",
            "telephone_number": "208-525-2600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSTIAN",
        "first_name": "ROBERTA",
        "middle_name": "J.",
        "credential": "AGACNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-01",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "ID",
            "license": "68854",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "UT",
            "license": "12751401-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bonneville Vision, PLLC
• Taylor Bonning, BS
• Ethan Bryan Booker, LMSW
• Julia Booker
• Brandon Derrick Borchman, PSY.D.
• Rosalinda Cruz Bourasa
• Jacqueline Jean Bowcutt
• Jeremy Bowen, PHARMD
• John Bowen
• Kate Bowen, SLP

• Acute Care Nurse Practitioner in Idaho Falls, ID
• Providers in Idaho Falls, ID by specialty
• Acute Care Nurse Practitioner in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2023; 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.