James Edward Boscardin, PH.D.

Primary specialty

PsychologistTaxonomy code 103T00000X

License

LP0709 Issued in MN

Practice address

8085 Wayzata Blvd
Suite 100B
Golden Valley, MN 55426-1453

Phone

(612) 719-0856

Fax

(651) 484-8551

NPI assigned

Nov 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 6

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Center for Psychological Consultation, P.a.

  • Clinical Psychologist
  • Golden Valley, MN
  • NPI 1407123425
  NPD Authorized official

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

{
    "created_epoch": "1162512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321574400000",
    "number": "1972682847",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1092 LAWNVIEW AVE",
            "city": "SHOREVIEW",
            "state": "MN",
            "postal_code": "551268408",
            "telephone_number": "612-719-0856",
            "fax_number": "651-484-8551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8085 WAYZATA BLVD",
            "address_2": "SUITE 100B",
            "city": "GOLDEN VALLEY",
            "state": "MN",
            "postal_code": "554261453",
            "telephone_number": "612-719-0856",
            "fax_number": "651-484-8551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOSCARDIN",
        "first_name": "JAMES",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-03",
        "last_updated": "2011-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MN",
            "license": "LP0709",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MN",
            "license": "LP0709",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MN",
            "license": "LP0709",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MN",
            "license": "LP0709",
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MN",
            "license": "LP0709",
            "primary": true
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MN",
            "license": "LP0709",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "710552500",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Janelle Bonniwell, OTR/L
• Amy Jo Bonsen, PTA
• Daniel Borgen, M.D.
• Kate Borkowski
• Stuart Borne, MED, ATC, CSCS
• Celeste L. Bour, OTR/L
• Kristina Boylan, MA LMFT
• Carmen Bradbury
• Michael James Bradbury, PT
• Mollie Mary Rose Brady, LPCC

• Psychologist in Golden Valley, MN
• Providers in Golden Valley, MN by specialty
• Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2011; 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.