NPIMap

Individual provider Active NPI

Joel C Bolen, MD

  • Geriatric Medicine (Internal Medicine) Physician
  • Montgomery, AL
National Provider Identifier
1063576130
Registry record updated Oct 25, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
License
20157 Issued in AL
Practice address
1230 Carmichael Way
Montgomery, AL 36106-3671
Phone
(334) 277-7665
Fax
(334) 277-7142
NPI assigned
Dec 21, 2006
Last updated
Oct 25, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) Physician 207RG0300X 20157 AL Primary

Addresses

Primary practice location

1230 Carmichael Way
Montgomery, AL 36106-3671

Mailing address

1230 Carmichael Way
Montgomery, AL 36106-3671
Phone (337) 277-7665

Other identifiers 3

IdentifierTypeStateIssuer
51021380OtherALBLUE CROSS
000036956MedicaidAL
51036956OtherALBCBSAL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100607000864 AL Practitioner - Internal MedicinePractitioner - Geriatric Medicine 0345271334 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Geriatric Medicine
Education
Wake Forest University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Geriatric Associates of Montgomery, PCGroup PAC ID 5991738213, 2 clinicians

Practice addresses (Care Compare)

1230 Carmichael Way
Montgomery, AL 36106-3671
Phone (334) 277-7665

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
43.01 of 100Reported as individual
Quality
26.67
Improvement activities
0
Cost
75.38

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
20157ALMDGeriatric Medicine (Internal Medicine) Physician
2057ALMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jackson Hospital & Clinic, Inc. Past Accepting new patients
Sunbridge Healthcare LLC Past Accepting new patients
Amedisys Alabama, LLC Past Accepting new patients
Diversicare of Montgomery, LLC Past Accepting new patients
Crowne Health Care of Montgomery, LLC Past Accepting new patients

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Merry Wood LodgeElmore, AL, CCN 015019 Skilled nursing facility Contracted Managing Employee
Adp of the SNF		 Mar 1, 2024
Dec 16, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1166659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1477353600000",
    "number": "1063576130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1230 CARMICHAEL WAY",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063671",
            "telephone_number": "337-277-7665",
            "fax_number": "334-277-7142"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 CARMICHAEL WAY",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361063671",
            "telephone_number": "334-277-7665",
            "fax_number": "334-277-7142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLEN",
        "first_name": "JOEL",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-21",
        "last_updated": "2016-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "AL",
            "license": "20157",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "51021380",
            "state": "AL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000036956",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBSAL",
            "identifier": "51036956",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.