KELLILYNN BOSAK (LCSW) – Clinical Social Worker, NPI 1205363421
Clinical Social Worker
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for KELLILYNN BOSAK (LCSW)
North Bend Medical Center, 1900, Woodland Drive, Coos Bay, Coos County, Oregon, 97420, United States
COOS BAY, OR 974202099
Phone: (541) 267-5151
Fax: (541) 266-4554
Type: Location
1900 Woodland Dr
Coos Bay, OR 974202099
Phone: (541) 267-5151
Fax: (541) 266-4554
Type: Location
150 S WALL ST
COOS BAY, OR 974203233
Phone: (541) 435-7200
Type: Location
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: 2020-05-27
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 |
|---|---|---|---|---|
| I20170705001212 | I | Clinical Social Worker | IL | TBD |
| I20200527000384 | I | Clinical Social Worker | OR | 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 |
|---|---|---|---|---|
| 90832 | Psychotherapy, 30 minutes | 169 | 57 | $0 |
| 90834 | Psychotherapy, 45 minutes | 99 | 35 | $0 |
| 99494 | Psychiatric collaborative care management per calendar month, each additional 30 minutes | 75 | 18 | $0 |
| 99493 | Follow-up psychiatric collaborative care management, subsequent calendar month, first 60 minutes | 67 | 16 | $0 |
| 99492 | Initial psychiatric collaborative care management, first calendar month, first 70 minutes | 19 | 19 | $0 |
Insurance plans in this area (ZIP 97420)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Family Practice | IL | |
| - | IL | |
| Clinical Social Worker | IL | |
| Family Practice | IL | |
| - | IL | |
| Hospitalist, Family Practice | IL | |
| - | IL | |
| Family Practice | IL | |
| Nurse Practitioner | IL | |
| Family Practice | MI |
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