Henry M Bolin, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

6810 Issued in AZ

Practice address

2730 S Val Vista Dr Ste 187
Gilbert, AZ 85295-1684

Phone

(480) 324-0300

Fax

(480) 324-0324

NPI assigned

Oct 3, 2017

Last updated

Apr 21, 2021By the provider in NPPES

Sex

Male

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 AZ

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/IBHHAD

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.

• American Family Medicine LLC

  • Family Medicine Physician
  • Phoenix, AZ
  • NPI 1477908085
  Medicare reassignment
• Clinica la Familia, PC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1780668921
  Medicare reassignment
• Gila Internal Medicine & Geriatric P C

  • Exclusive Provider Organization
  • Tempe, AZ
  • NPI 1609921378
  Medicare reassignment
• American Family Medicine LLC

  • Pediatrics Physician
  • Phoenix, AZ
  • NPI 1164287124

  Physician Assistant

  NPD
• Desert Kidney Associates PLC

  • Nephrology Physician
  • Mesa, AZ
  • NPI 1144372905
  NPD (past)

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

{
    "created_epoch": "1506988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1164932299",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DR STE 187",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951684",
            "telephone_number": "480-324-0300",
            "fax_number": "480-324-0324"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 S VAL VISTA DR STE 187",
            "city": "GILBERT",
            "state": "AZ",
            "postal_code": "852951684",
            "telephone_number": "480-324-0300",
            "fax_number": "480-324-0324"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIN",
        "first_name": "HENRY",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-10-03",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "AZ",
            "license": "6810",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AZ LICENSE NUMBER",
            "identifier": "6810",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Amy E Bohan, MD
• Taylor Phillip Bohne, PT, DPT, ATC, LAT
• Boj Health Corp (Boj Residential Home)
• Sarah Lee Bolander, DMSC, PA-C, DFAAPA
• Steve Babyboy Bolay
• Janna Marie Bolingbroke, LCSW
• Jonathan E. Bolles, PA-C
• Denise Bollinger, SLP
• Jacqueline Yi Bollinger, DDS
• Samuel Walker Bollwinkel, DDS

• Medical Physician Assistant in Gilbert, AZ
• Providers in Gilbert, AZ by specialty
• Medical Physician Assistant in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.