Krista D Bolanger, PA

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

50 002179 Issued in OH

Practice address

9000 N Main St
Suite 227
Dayton, OH 45415-1180

Phone

(937) 832-4773

Fax

(937) 832-2986

NPI assigned

Feb 1, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Premier Health Specialists IncGroup PAC ID 5597708594, 576 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Miami Valley Hospital Hospital, Dayton, OH, CCN 360051

Merit-based Incentive Payment System (MIPS)

Final score

81.38 of 100Reported as group

Quality

66.25

Promoting interoperability

100

Improvement activities

40

Cost

71.69

Merit-based Incentive Payment System (MIPS)

Final score

87.12 of 100Reported as group

Quality

84.25

Promoting interoperability

100

Improvement activities

40

Cost

72.81

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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

• Premier Health Specialists Inc

  • Internal Medicine Physician
  • Moraine, OH
  • NPI 1194958223
  Medicare reassignment Care Compare group
• Uvpc Specialists Inc.

  • Surgery Physician
  • Troy, OH
  • NPI 1831115492
  Medicare reassignment NPD
• Premier Health Specialists Inc

  dba Premier OBGyn

  • Obstetrics & Gynecology Physician
  • Springboro, OH
  • NPI 1558667261
  NPD
• Premier Health Specialists Inc

  dba Advanced Ankle and Foot Specialists

  • Foot & Ankle Surgery Podiatrist
  • Dayton, OH
  • NPI 1902211287
  NPD
• Premier Cardiothoracic and Vascular Surgeons Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Dayton, OH
  • NPI 1811944531
  NPD (past)
• Premier Heart Associates, Inc

  • Cardiovascular Disease Physician
  • Beavercreek, OH
  • NPI 1538188735
  NPD (past)

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

• Miami Valley Hospital

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1073688354
  Care Compare affiliation

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1073651337",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST",
            "address_2": "SUITE 227",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-832-4773",
            "fax_number": "937-832-2986"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9000 N MAIN ST",
            "address_2": "SUITE 227",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454151180",
            "telephone_number": "937-832-4773",
            "fax_number": "937-832-2986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANGER",
        "first_name": "KRISTA",
        "middle_name": "D",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-01",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "OH",
            "license": "50 002179",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0067813",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sheri Marie Bohannon, LSW
• Rudy Jordan Bohinc, DO
• John J Bohls
• Richard Kurt Alexander Bohme, DDS, FAGD
• Amy Sue Bokal, M.D.
• Chynne Kierra Bolden, LSW, MSW
• Nicole Bolden, PEER SUPPORT
• Tyrone Bolden
• Christopher Boldi, PHARM.D.
• Frederick Santi Boldi, CRNA

• Medical Physician Assistant in Dayton, OH
• Providers in Dayton, OH by specialty
• Medical Physician Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.