Individual provider Active NPI

Jonathan Andrew Bolles, MD

  • Cardiovascular Disease Physician
  • Wenatchee, WA
National Provider Identifier
1003839093
Registry record updated Jul 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
MD60260896 Issued in WA
Practice address
1201 S Miller St Ste a
Wenatchee, WA 98801-3201
Phone
(509) 663-8711
NPI assigned
Jul 25, 2006
Last updated
Jul 14, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 14, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 23017 NE
Cardiovascular Disease Physician 207RC0000X MD60260896 WA Primary

Addresses

Primary practice location

1201 S Miller St Ste a
Wenatchee, WA 98801-3201

Mailing address

820 N Chelan Ave
Wenatchee, WA 98801-2028
Phone (509) 663-8711

Other identifiers 3

IdentifierTypeStateIssuer
P01096688OtherWARR MEDICARE WVH
315727OtherWAWVH LNI
1003839093MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120718000972 WA Practitioner - Cardiovascular Disease (Cardiology)Practitioner - Internal Medicine 6800052804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)Also: Internal Medicine
Education
University of Vermont College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1201 S Miller St
Wenatchee, WA 98801-3201
Phone (509) 662-2208

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
23017NEMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wenatchee Valley Hospital CurrentSince Jul 21, 2013 Accepting new patients
Central Washington Health Services Association Current Accepting new patients
Central Washington Health Services Association CurrentSince Dec 1, 2017 Accepting new patients
Ozark Tri-County Health Care Consortium Past Accepting new patients

Locations

303 Cottage Ave
Cashmere, WA 98815
Phone (509) 782-1541

840 E Hill Ave
Moses Lake, WA 98837
Phone (509) 764-6400

916 Koala Dr
Omak, WA 98841
Phone (509) 826-1800

17 S Western Ave
Tonasket, WA 98855
Phone (509) 486-2174

100 Highline Dr
Wenatchee, WA 98802
Phone (509) 884-0614

1201 S Miller St
Wenatchee, WA 98801
Phone (509) 662-2208

1201 S Miller St
Ste A
Wenatchee, WA 98801
Phone (509) 667-2003

820 N Chelan Ave
Wenatchee, WA 98801
Phone (509) 863-4868

933 Red Apple Rd
Wenatchee, WA 98801
Phone (509) 655-6125

Interoperability endpoints

  • FHIR API: https://fhir-usa.unify.chbase.com/org/okanogn-4f3d63fb
  • Direct secure messaging: jbolles17339@edirect.chehr.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1003839093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 S MILLER ST STE A",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013201",
            "telephone_number": "509-663-8711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLES",
        "first_name": "JONATHAN",
        "middle_name": "ANDREW",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-25",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "NE",
            "license": "23017",
            "primary": false
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "WA",
            "license": "MD60260896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE WVH",
            "identifier": "P01096688",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WVH LNI",
            "identifier": "315727",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1003839093",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.