Marya Mei Bolyanatz, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

10508 Issued in CA

Practice address

1250 Peach Street
Suite a
San Luis Obispo, CA 93401-2837

Phone

(805) 543-4043

Fax

(805) 543-7640

NPI assigned

Aug 30, 2005

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 CA

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

Nurse Practitioner

Education

Other, 2005

Medicare assignment

May accept Medicare assignment

Group practices

Eon Care Clinicians of Ca PCGroup PAC ID 9739609199, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Eon Care Clinicians of Ca, PC

  • Nurse Practitioner
  • Germantown, MD
  • NPI 1831919760

  CA

  Medicare reassignment Care Compare group NPD
• Cottage Clinical Network, LLC

  • Urgent Care Clinic/Center
  • Santa Barbara, CA
  • NPI 1588209357
  Medicare reassignment NPD
• Cottage Medical Associates

  • Internal Medicine Physician
  • Santa Barbara, CA
  • NPI 1972669562
  NPD (past)
• Pacific Central Coast Health Centers

  • Community Health Clinic/Center
  • Bakersfield, CA
  • NPI 1720752355
  NPD (past)

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

{
    "created_epoch": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1451088000000",
    "number": "1164415501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 WEST BUNNY AVENUE",
            "city": "SANTA MARIA",
            "state": "CA",
            "postal_code": "934582805",
            "telephone_number": "805-543-4043",
            "fax_number": "805-543-7640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 PEACH STREET",
            "address_2": "SUITE A",
            "city": "SAN LUIS OBISPO",
            "state": "CA",
            "postal_code": "934012837",
            "telephone_number": "805-543-4043",
            "fax_number": "805-543-7640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLYANATZ",
        "first_name": "MARYA",
        "middle_name": "MEI",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-30",
        "last_updated": "2015-12-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "CA",
            "license": "10508",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE ID",
            "identifier": "CB236600",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brian Bolenbaugh
• Olivia Zoleta Boles
• Ann L Bollay, MD
• Callie Rose Boller
• Jill Bolster-White
• Jimmy Bond, D.D.S.
• Sandra Bond
• Rhaelynn Bonham, NP
• David Carlton Bonnheim, M.D.
• Wilaim David Boorman, PSYCHIATRIC TECHNICI

• Family Nurse Practitioner in San Luis Obispo, CA
• Providers in San Luis Obispo, CA by specialty
• Family Nurse Practitioner in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 26, 2015; 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.