Kevin Michael Bos, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4901004784 Issued in MI

Practice address

100 Cherry St SE
Optometry Clinic
Grand Rapids, MI 49503-4526

Phone

(616) 965-8200

NPI assigned

Jul 24, 2013

Last updated

Jul 24, 2013By 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 1

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Ferris State College - College of Optometry, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cherry Street Services IncGroup PAC ID 6800707647, 58 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kevin.bos.p1@direct.cherryhealth.nextgenshare.com

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.

• Cherry Street Services, Inc.

  dba Cherry Street Health Services

  • Federally Qualified Health Center (FQHC)
  • Grand Rapids, MI
  • NPI 1558459164
  Medicare reassignment Care Compare group NPD
• Cherry Street Services, Inc

  dba Cherry Health - Tri County Middle School

  • Federally Qualified Health Center (FQHC)
  • Howard City, MI
  • NPI 1831955251
  NPD
• Cherry Street Services Inc

  dba Wyoming Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Wyoming, MI
  • NPI 1184974263

  Optometrist

  NPD (past)

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

{
    "created_epoch": "1374624000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1374624000000",
    "number": "1982046504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2257 KINNROW AVE NW",
            "city": "WALKER",
            "state": "MI",
            "postal_code": "495341281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 CHERRY ST SE",
            "address_2": "OPTOMETRY CLINIC",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495034526",
            "telephone_number": "616-965-8200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOS",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-24",
        "last_updated": "2013-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MI",
            "license": "4901004784",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF OPTOMETRY",
            "identifier": "4901004784",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Gina Menuez Borton, LLPC
• Kristina Borton, TLLP
• Madison Borucki
• Cindy R Bos, MD
• Karen Lynn Bos, PT
• Carol Mae M Bosanko, MD
• Lily Bosch
• Ronald Bosch, MSW
• Laura Haist Bose, PA-C
• Cassie Boshoven

• Optometrist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Optometrist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2013; 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.