Individual provider Active NPI

Frederick Joseph Boltz, M.D.

  • Specialist
  • Boca Raton, FL
National Provider Identifier
1003907890
Registry record updated Nov 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
ME0052045 Issued in FL
Practice address
1601 Clint Moore Rd.
Suite 120
Boca Raton, FL 33487
Phone
(561) 939-0300
Fax
(561) 939-0339
NPI assigned
Sep 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X ME0052045 FL Primary

Addresses

Primary practice location

1601 Clint Moore Rd.
Suite 120
Boca Raton, FL 33487

Mailing address

1601 Clint Moore Rd.
Suite 120
Boca Raton, FL 33487
Phone (561) 939-0300

Other identifiers 1

IdentifierTypeStateIssuer
05851OtherFLINDIVIDUAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20100712000622 FL Practitioner - Neurology 9335271238 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Other, 1982
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
South Florida Neurology Associates PAGroup PAC ID 1355319823, 9 clinicians

Practice addresses (Care Compare)

1601 Clint Moore Rd
Suite 120
Boca Raton, FL 33487-5712
Phone (561) 939-0300

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME0052045FLMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
South Florida Neurology Associates PA Specialist CurrentSince Feb 8, 1988 Accepting new patients

Locations

1601 Clint Moore Rd
Ste 120
Boca Raton, FL 33487
Phone (561) 270-2280

Organizations & group practices 1

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

Hospital & facility affiliations 3

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": "1159315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1479340800000",
    "number": "1003907890",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1601 CLINT MOORE RD.",
            "address_2": "SUITE 120",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33487",
            "telephone_number": "561-939-0300",
            "fax_number": "561-939-0339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1601 CLINT MOORE RD.",
            "address_2": "SUITE 120",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "33487",
            "telephone_number": "561-939-0300",
            "fax_number": "561-939-0339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTZ",
        "first_name": "FREDERICK",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-27",
        "last_updated": "2016-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "FL",
            "license": "ME0052045",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INDIVIDUAL",
            "identifier": "05851",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.