DR. MARK O BOSTROM (DO) – Internal Medicine Physician, NPI 1902990419

DR. MARK O BOSTROM (DO) is a healthcare provider. based in Crosby, Minnesota. specializing in INTERNAL MEDICINE. They hold the professional credentials DO. They hold a License No. 38115 (MN). The NPI Number for DR. MARK O BOSTROM (DO) is 1902990419

Main info

Male
32 Years Of Experience
Accepts Medicare Assignment
Name
DR. MARK O BOSTROM (DO)
NPI
1902990419
Phone
(218) 546-7000
Address
320 EAST MAIN STREET
Enumeration Date
2 October 2006
Last Update Date
19 November 2020

Doctor Profile

Medical School Name
ROWAN UNIVERSITY SCHOOL OF OSTEOPATHIC MEDICINE
Secondary Phone
2185467000
Graduation Year
1994 (32 years ago)
PAC ID
6305745167
Group Practice PAC ID
9537146550
Professional Enrollment ID
I20050512000430
Address ID
MN564411645CR320XXSTXX400

Contacts

Secure Messaging
mbostrom155762@excellian.direct.allina.com
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience67
Completeness85
Years active:19State licenses:1Other namesUpdated within 12 months

3,638 INTERNAL MEDICINE in MN

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Provider Addresses for DR. MARK O BOSTROM (DO)

  • Cuyuna Regional Medical Center, 320, East Main Street, Towns Edge Mobile Home Park, Crosby, Crow Wing County, Minnesota, 56441, United States

    CROSBY, MN 56441

    Phone: (218) 546-7000

    Fax: (218) 546-4400

    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: 2005-05-12

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

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20050512000430IInternal MedicineMNTBD

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.

Verify on CMS Revalidation Lookup Tool

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

HCPCSDescriptionServicesBeneficiariesMedicare allowed
93010Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only6146$0
36415Insertion of needle into vein for collection of blood sample1611$0
View full utilization report →

Insurance plans in this area (ZIP 56441)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 9537146550View full group profile
NameSpecialtyState
Physician AssistantMN
Nurse PractitionerMN
-MN
Nurse PractitionerMN
Family PracticeMN
Certified Registered Nurse Anesthetist (Crna)IN
H O S P I T A L I S TMN
Nurse PractitionerMN
Internal Medicine, Hospitalist, Internal MedicineFL
Family PracticeMN

Reviews

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Frequently asked questions

What number should I use to identify DR. MARK O BOSTROM (DO) for billing?
Administrative and clinical systems typically use NPI 1902990419 for DR. MARK O BOSTROM (DO).
Quick check: is DR. MARK O BOSTROM (DO) active?
Public NPPES data shows DR. MARK O BOSTROM (DO) with an active NPI status right now.
What type of care does DR. MARK O BOSTROM (DO) provide?
DR. MARK O BOSTROM (DO)'s profile centers on Internal Medicine Physician. Clinical services aligned with this taxonomy classification.
Is DR. MARK O BOSTROM (DO) tied to Crosby, Minnesota?
If you are local to Crosby, Minnesota, DR. MARK O BOSTROM (DO) may be relevant to your search.
Can I verify credentials using only NPI?
NPI confirms identity in the directory; licensure and board certification require separate checks.

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