Gordon Bolles, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

309573 Issued in NY

Practice address

100 High St
Buffalo, NY 14203-1126

Phone

(716) 859-5600

NPI assigned

Apr 27, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Buffalo Medical Group, P.C.Group PAC ID 7012820301, 233 clinicians

Sisters of Charity Hospital of Buffalo New YorkGroup PAC ID 6204749153, 160 clinicians

Mercy Hospital of BuffaloGroup PAC ID 8729991666, 198 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Mercy Hospital of Buffalo Hospital, Buffalo, NY, CCN 330279
• Sisters of Charity Hospital Hospital, Buffalo, NY, CCN 330078

Merit-based Incentive Payment System (MIPS)

Final score

91.31 of 100Reported as group

Quality

87.9

Promoting interoperability

100

Improvement activities

40

Cost

83.14

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Buffalo Medical Group, P.C.

  • Family Medicine Physician
  • Williamsville, NY
  • NPI 1881659506

  NY

  Medicare reassignment Care Compare group NPD
• Mercy Hospital of Buffalo

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1164464921

  NY

  Medicare reassignment Care Compare group NPD
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1790727543

  NY

  Medicare reassignment Care Compare group NPD
• Buffalo Medical Group, P.C.

  • Durable Medical Equipment & Medical Supplies
  • Lockport, NY
  • NPI 1982566782
  NPD
• Mercy Hospital of Buffalo

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1851929954

  Nurse Practitioner

  NPD
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Cheektowaga, NY
  • NPI 1043455199
  NPD
• Mercy Hospital of Buffalo

  • Rehabilitation Hospital Unit
  • Buffalo, NY
  • NPI 1659310605
  NPD (past)

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

• Mercy Hospital of Buffalo

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1164464921

  Hospital

  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Cheektowaga, NY
  • NPI 1043455199

  Hospital

  Care Compare affiliation
• Sisters of Charity Hospital of Buffalo New York

  • General Acute Care Hospital
  • Buffalo, NY
  • NPI 1790727543

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1587945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1013538461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 ESSJAY RD STE 170",
            "city": "WILLIAMSVILLE",
            "state": "NY",
            "postal_code": "142218235",
            "telephone_number": "716-630-1219"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HIGH ST",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142031126",
            "telephone_number": "716-859-5600"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2605 Harlem Rd",
            "address_purpose": "LOCATION",
            "city": "Cheektowaga",
            "state": "NY",
            "postal_code": "142254018",
            "country_code": "US",
            "telephone_number": "716-891-2400",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "565 Abbott Rd",
            "address_purpose": "LOCATION",
            "city": "Buffalo",
            "state": "NY",
            "postal_code": "142202095",
            "country_code": "US",
            "telephone_number": "716-826-7000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLLES",
        "first_name": "GORDON",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-04-27",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "NY",
            "license": "309573",
            "primary": false
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NY",
            "license": "309573",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Rose Bojrab, DPM
• Mamoon Bokhari, MD
• Sarah Jane Boland, COTA/L
• Inderjit Bolla, M.D.
• Emily Boller, RN
• Andie Marie Bolton
• Hannah Boltz
• Jillian Florence Boltz
• Christopher Bona
• Diane Bona, NP

• All providers in Buffalo, NY
• Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.