Jack Bosma, PT, DPT, CSCS
NPI 1558194936ActiveIndividual· Physical Therapist· Saint Augustine, FL
Physical Therapist (PT, DPT, CSCS) with Atlas Physical Therapy and Sports Medicine Inc, practicing in Saint Augustine, Florida. Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1558194936 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PT, DPT, CSCS |
| Sole proprietor | No |
| NPI issued | Aug 21, 2024 |
| Last updated in NPPES | Aug 21, 2024 |
| Certified by provider | Aug 21, 2024 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | 41649 | FL |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (FL) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Atlas Physical Therapy and Sports Medicine IncJacksonville, FL · 11 clinicians
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