Active NPI
David Bolon
- Cardiovascular Disease Physician
- New York, NY
National Provider Identifier
1033184205
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cardiovascular Disease Physician
- License
- 208240
- Practice address
- 133 E 58TH St Ste 1402
New York, NY 10022-1236 - Phone
- (646) 705-0035
- Fax
- (877) 409-1860
- NPI assigned
- Feb 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nuclear Cardiology Physician | 207UN0901X | 208240 | NY | |
| Cardiovascular Disease Physician | 207RC0000X | 208240 | NY | Primary |
Addresses
Primary practice location
133 E 58TH St Ste 1402
New York, NY 10022-1236
Mailing address
405 Greenwich St Apt 5
New York, NY 10013-2047
Phone (646) 279-0688
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
- Opted out of Medicare
- Yes, effective Apr 1, 2025 through Apr 1, 2027
Care Compare profile
Medicare Care Compare- Specialty
- Cardiovascular Disease (Cardiology)
- Education
- New York University School of Medicine, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
133 E 58TH St
Unit 1402
New York, NY 10022-1236
Merit-based Incentive Payment System (MIPS)
- Final score
- 19.88 of 100
- Quality
- 0
- Improvement activities
- 0
- Cost
- 66.27
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Interoperability endpoints
- dbolon64547@northwell.direct-ci.com
- https://fhir4.healow.com/fhir/r4/EECHCD/Endpoint/EECHCD
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1140480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1653436800000",
"number": "1033184205",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "405 GREENWICH ST APT 5",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100132047",
"telephone_number": "646-279-0688",
"fax_number": "877-409-1860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "133 E 58TH ST STE 1402",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100221236",
"telephone_number": "646-705-0035",
"fax_number": "877-409-1860"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLON",
"first_name": "DAVID",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-02-21",
"last_updated": "2022-05-25",
"certification_date": "2022-05-09",
"status": "A"
},
"taxonomies": [
{
"code": "207UN0901X",
"taxonomy_group": "",
"desc": "Nuclear Medicine, Nuclear Cardiology",
"state": "NY",
"license": "208240",
"primary": false
},
{
"code": "207RC0000X",
"taxonomy_group": "",
"desc": "Internal Medicine, Cardiovascular Disease",
"state": "NY",
"license": "208240",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 25, 2022; 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; Opt Out Affidavits.
- 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.