DR. MELISSA SUE BOSMA (MD) – Diagnostic Radiology Physician, NPI 1053549956
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
847 DIAGNOSTIC RADIOLOGY in IN
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Provider Addresses for DR. MELISSA SUE BOSMA (MD)
3707, New Vision Drive, Fort Wayne, Allen County, Indiana, 46845, United States
FORT WAYNE, IN 468451702
Phone: (260) 469-4763
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2015-06-08
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20140716001806 | I | Diagnostic Radiology | MI | TBD |
| I20150529002253 | I | Diagnostic Radiology | OH | TBD |
| I20150608002282 | I | Diagnostic Radiology | IN | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 77067 | Screening mammography | 1,364 | 1,364 | $0 |
| 77063 | Screening 3d breast mammography | 1,361 | 1,361 | $0 |
| G0279 | Diagnostic digital breast tomosynthesis, unilateral or bilateral (list separately in addition to 77065 or 77066) | 305 | 299 | $0 |
| 76642 | Limited ultrasound scan of 1 breast | 282 | 275 | $0 |
| 77065 | Diagnostic mammography of 1 breast | 219 | 203 | $0 |
Insurance plans in this area (ZIP 46845)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | IN | 71250 | CT scan chest | 21 | 21 |
| DIAGNOSTIC RADIOLOGY | IN | 73110 | X-ray of wrist, minimum of 3 views | 23 | 23 |
| DIAGNOSTIC RADIOLOGY | IN | 73562 | X-ray of knee, 3 views | 28 | 21 |
| DIAGNOSTIC RADIOLOGY | IN | 73630 | X-ray of foot, minimum of 3 views | 47 | 46 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Interventional Radiology, Diagnostic Radiology | IN | |
| - | IN | |
| Physician Assistant | IN | |
| Diagnostic Radiology | IN | |
| Diagnostic Radiology | IN | |
| - | IN | |
| Physician Assistant | IN | |
| Physician Assistant | OH | |
| - | WI | |
| - | IN |
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