JACKIE LYNN BOSSHART (OTR/L) – Occupational Therapist, NPI 1801041447
Occupational Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
603 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in MN
Provider Addresses for JACKIE LYNN BOSSHART (OTR/L)
1901CONNECTICUT AVENUE SOUTH
ST CLOUD ORTHOPEDIC ASSOCIATES, LTD.
SARTELL, MN 56377
Phone: (320) 259-4141
Fax: (320) 257-7811
Type: Location
605, Brittany Blvd, Foley, Benton County, Minnesota, 56329, United States
FOLEY, MN 563298430
Phone: (320) 968-7153
Type: Mailing
1901Connecticut Avenue South
St Cloud Orthopedic Associates, Ltd.
Sartell, MN 56377
Phone: (320) 259-4141
Fax: (320) 257-7811
Type: Location
10230 BALTIMORE ST NE STE 300
BLAINE, MN 554494674
Phone: (651) 968-5201
Fax: (651) 968-5903
Type: Location
710 COMMERCE DR STE 200
WOODBURY, MN 551254925
Phone:
Type: Mailing
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: 2009-01-20
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
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 |
|---|---|---|---|---|
| I20090120000559 | I | Occupational Therapist In Private Practice | MN | 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.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 56377)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | MN | |
| - | MN | |
| - | MN | |
| Orthopedic Surgery, Sports Medicine | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN | |
| - | MN | |
| Physical Therapist In Private Practice | MN |
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