Individual provider Active NPI

Chelsea Boltja, PA-C

  • Reproductive Endocrinology Physician
  • New York, NY
National Provider Identifier
1073050936
Registry record updated Mar 5, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Reproductive Endocrinology PhysicianTaxonomy code 207VE0102X
License
023436-1 Issued in NY
Practice address
810 Seventh Ave FL 21
New York, NY 10019-5923
Phone
(212) 290-8100
NPI assigned
Jan 30, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 001007021 NC
Reproductive Endocrinology Physician 207VE0102X 023436-1 NY Primary

Addresses

Primary practice location

810 Seventh Ave FL 21
New York, NY 10019-5923

Mailing address

810 Seventh Ave FL 21
New York, NY 10019-5923

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
023436-1NYMDReproductive Endocrinology Physician
001007021NCMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1485734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614902400000",
    "number": "1073050936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "810 SEVENTH AVE FL 21",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 SEVENTH AVE FL 21",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100195923",
            "telephone_number": "212-290-8100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTJA",
        "first_name": "CHELSEA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-01-30",
        "last_updated": "2021-03-05",
        "certification_date": "2021-03-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "001007021",
            "primary": false
        },
        {
            "code": "207VE0102X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
            "state": "NY",
            "license": "023436-1",
            "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 Mar 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.