PETER J BOOSALIS (MD) – Anesthesiology Physician, NPI 1174577316
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
969 ANESTHESIOLOGY in MN
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Provider Addresses for PETER J BOOSALIS (MD)
14700, 28th Avenue North, Plymouth, Hennepin County, Minnesota, 55447, United States
SUITE 20
PLYMOUTH, MN 554474835
Phone: (763) 559-3779
Fax: (763) 450-3986
Type: Mailing
Lakeview Hospital, 927, Churchill Street West, Stillwater, Washington County, Minnesota, 55082, United States
STILLWATER, MN 550826605
Phone: (651) 430-4585
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $7.
Total Amount is formed as General ($7) + Research ($0) + Ownership ($0) = $7.
Last reported payment date: 2024-05-09 • Largest payer in this snapshot: Ambu Inc. ($7).
Total Amount
$7
General + Research + Ownership
Payments
1
Total payment records
General Amount
$7
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-05-09
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Ambu Inc. | $7 |
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: 2023-11-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20150521002820 | I | Anesthesiology | WI | TBD |
| I20231109001641 | I | Anesthesiology | GA | 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 |
|---|---|---|---|---|
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 31 | 30 | $0 |
| 00910 | Anesthesia for other procedure on urinary system through urethra | 16 | 16 | $0 |
| 00813 | Anesthesia for procedure on small and large bowel using an endoscope | 14 | 14 | $0 |
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 12 | 11 | $0 |
Insurance plans in this area (ZIP 55447)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Certified Registered Nurse Anesthetist (Crna) | LA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| A N E S T H E S I O L O G Y | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| A N E S T H E S I O L O G Y | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Certified Registered Nurse Anesthetist (Crna) | GA | |
| Certified Registered Nurse Anesthetist (Crna) | MN |
Reviews
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