Individual provider Active NPI

Robert John Bollo, MD

  • Neurological Surgery Physician
  • Salt Lake City, UT
National Provider Identifier
1013129584
Registry record updated Oct 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
7625702-1205 Issued in UT
Practice address
50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone
(801) 581-6908
NPI assigned
May 4, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 244054 NY
Neurological Surgery Physician 207T00000X 7625702-1205 UT Primary
Neurological Surgery Physician 207T00000X P0701 TX

Addresses

Primary practice location

50 N Medical Dr
Salt Lake City, UT 84132-0100

Mailing address

PO Box 413030
Salt Lake City, UT 84141-3030
Phone (801) 213-3900

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address rbollo16634@direct.med.utah.edu Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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
I20130426000289 UT Practitioner - Neurosurgery 6305017286 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurosurgery
Education
Boston University School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

100 N Mario Capecchi Dr
Salt Lake City, UT 84113-1103
Phone (801) 587-7109

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
244054NYMDNeurological Surgery Physician
7625702-1205UTMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
University of Utah Surgical Services Current Accepting new patients
Ihc Health Services Inc Family Medicine CurrentSince May 3, 2013 Accepting new patients
University of Utah Pediatric Services CurrentSince Aug 1, 2016 Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Adult Services Current Accepting new patients
University of Utah Pediatric Services CurrentSince Aug 1, 2016 Accepting new patients
University of Utah Adult Services CurrentSince Feb 1, 2015 Accepting new patients
University of Utah Surgical Services Neurological Surgery CurrentSince Dec 1, 2014 Accepting new patients
University of Utah Pediatric Services Current Accepting new patients
University of Utah Surgical Services Neurological Surgery CurrentSince Dec 1, 2014 Accepting new patients
Ihc Health Services, Inc. CurrentSince May 3, 2013 Accepting new patients
Ihc Health Services Inc Past Accepting new patients
University of Utah Pediatric Services Past Accepting new patients

Locations

81 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 662-5700

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

100 N Mario Capecchi Dr
Slc, UT 84113
Phone (801) 587-7109

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

1380 E Medical Center Dr
#P
St George, UT 84790
Phone (435) 251-2355

Interoperability endpoints

  • Direct secure messaging: rbollo16634@direct.med.utah.edu

Organizations & group practices 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1178236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635379200000",
    "number": "1013129584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 413030",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841413030",
            "telephone_number": "801-213-3900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 N MEDICAL DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841320100",
            "telephone_number": "801-581-6908"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLO",
        "first_name": "ROBERT",
        "middle_name": "JOHN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-04",
        "last_updated": "2021-10-28",
        "certification_date": "2021-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "NY",
            "license": "244054",
            "primary": false
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "UT",
            "license": "7625702-1205",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "TX",
            "license": "P0701",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rbollo16634@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.