Individual provider Active NPI

Jena Michelle Bolte

  • Certified Registered Nurse Anesthetist
  • Cincinnati, OH
National Provider Identifier
1063037521
Registry record updated Jun 23, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
APRN.CRNA.0020113 Issued in OH
Practice address
375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone
(513) 862-2432
Fax
(513) 862-8857
NPI assigned
Jun 10, 2020
Last updated
Jun 23, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X APRN.CRNA.0020113 OH Primary
Registered Nurse 163W00000X 402199 OH

Addresses

Primary practice location

375 Dixmyth Ave
Cincinnati, OH 45220-2475

Mailing address

PO Box 632572
Cincinnati, OH 45263-2572
Phone (859) 341-2666

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200702000858 OH Practitioner - Certified Registered Nurse Anesthetist (Crna) 8224451687 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Anesthesia Group Practice IncGroup PAC ID 1254245137, 396 clinicians

Practice addresses (Care Compare)

375 Dixmyth Ave
Cincinnati, OH 45220-2475
Phone (513) 862-2432

Merit-based Incentive Payment System (MIPS)

Final score
93.01 of 100Reported as apm
Quality
86.02
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
402199OHMDRegistered Nurse
APRN.CRNA.0020113OHMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesia Group Practice, Inc Nurse Anesthetist, Certified Registered CurrentSince Jun 29, 2020 Accepting new patients

Locations

375 Dixmyth Ave
Cincinnati, OH 45220
Phone (513) 862-2432

538 Oak St
Cincinnati, OH 45219
Phone (513) 247-0224

10500 Montgomery Rd
Montgomery, OH 45242
Phone (513) 557-3206

500 E Business Way
Sharonville, OH 45241
Phone (513) 251-7827

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1591747200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1592870400000",
    "number": "1063037521",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 632572",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452632572",
            "telephone_number": "859-341-2666",
            "fax_number": "859-341-7867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "375 DIXMYTH AVE",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452202475",
            "telephone_number": "513-862-2432",
            "fax_number": "513-862-8857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTE",
        "first_name": "JENA",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-10",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "OH",
            "license": "APRN.CRNA.0020113",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "402199",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.