Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Bosak, DPT

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1417716440

Jacob Bosak, DPT is a Physical Therapist in Private Practice in Kansas City, Missouri. Qualified in 2023, 3 years ago. Practices with Athletico Ltd, a 2,186-clinician group and accepts Medicare assignment. Licensed in Kansas and Missouri.

Years since qualifying
3
Licensed in
KS, MO
In the registry since
2024
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

4029 Mill St
Kansas City, MO 64111-3008
Phone: (816) 285-0022
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 2024010773 (MO)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X · Licence 11-07566 (KS)

Record details

NPI number1417716440
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedMarch 13, 2024
Last updated in NPPESMay 31, 2024
Certification dateMay 31, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2023 (3 years in practice)
Group practice Athletico Ltd — 2186 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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