Individual provider Active NPI

Divya S Bolar, M.D.

  • Neuroradiology Physician
  • San Diego, CA
National Provider Identifier
1174888085
Registry record updated Jul 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neuroradiology PhysicianTaxonomy code 2085N0700X
License
A154915 Issued in CA
Practice address
200 W Arbor Dr
San Diego, CA 92103
Phone
(619) 543-2218
NPI assigned
Jul 6, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neuroradiology Physician 2085N0700X A154915 CA Primary

Addresses

Primary practice location

200 W Arbor Dr
San Diego, CA 92103

Mailing address

PO Box 232410
San Diego, CA 92193-2410

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180824000772 CA Practitioner - Diagnostic Radiology 3375771207 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Harvard Medical School, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Regents of the University of CaliforniaGroup PAC ID 3577476761, 2,047 clinicians

Practice addresses (Care Compare)

1415 Ross Ave
El Centro, CA 92243-4306
Phone (800) 926-8273

200 W Arbor Dr
San Diego, CA 92103-9000
Phone (858) 657-7000

447 N El Camino Real
Encinitas, CA 92024-1302
Phone (858) 657-7000

6655 Alvarado Rd
San Diego, CA 92120-5208
Phone (800) 926-8273

9300 Campus Point Dr
La Jolla, CA 92037-1300
Phone (800) 926-8273

9350 Campus Point Dr
La Jolla, CA 92037-1300
Phone (800) 926-8273

9400 Campus Point Dr
La Jolla, CA 92093-1350
Phone (800) 926-8273

9415 Campus Point Dr
La Jolla, CA 92093-1350
Phone (800) 926-8273

9434 Medical Ctr Dr
La Jolla, CA 92037-1337
Phone (800) 926-8273

9452 Medical Ctr Dr
La Jolla, CA 92037-1337
Phone (800) 926-8273

Hospital & facility affiliations

  • UC San Diego Health Hillcrest - Hillcrest Med Ctr Hospital, San Diego, CA, CCN 050025
  • El Centro Regional Medical Center Hospital, El Centro, CA, CCN 050045

Merit-based Incentive Payment System (MIPS)

Final score
90.77 of 100Reported as group
Quality
84.13
Promoting interoperability
100
Improvement activities
40
Cost
73.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Regents of the University of California Ucsd Department of Radiology CurrentSince Jun 23, 2018 Accepting new patients
Regents of the University of California Neuroradiology CurrentSince Jun 23, 2018 Accepting new patients
Regents of the University of California Past Accepting new patients
Regents of the University of California Ucsd Head and Neck Surgery Past Accepting new patients

Locations

9452 Medical Center Dr
La Jolla, CA 92037
Phone (858) 246-2016

9300 Campus Point Dr
La Jolla, CA 92037
Phone (619) 957-7000

9427 Health Scientists Dr
La Jolla, CA 92093

6655 Alvarado Rd
San Diego, CA 92120
Phone (619) 229-3130

4250 1st Ave
San Diego, CA 92103
Phone (415) 290-8175

330 Lewis St
Ste 400
San Diego, CA 92103
Phone (619) 471-9250

200 W Arbor Dr
San Diego, CA 92103
Phone (619) 543-5754

8929 University Center Ln
Ste 101
San Diego, CA 92122
Phone (858) 457-4227

8929 University Center Ln
San Diego, CA 92122
Phone (855) 543-0333

408 Dickinson St
San Diego, CA 92103
Phone (619) 471-0513

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1341532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532304000000",
    "number": "1174888085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 232410",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "921932410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 W ARBOR DR",
            "city": "SAN DIEGO",
            "state": "CA",
            "postal_code": "92103",
            "telephone_number": "619-543-2218"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLAR",
        "first_name": "DIVYA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-06",
        "last_updated": "2018-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085N0700X",
            "taxonomy_group": "",
            "desc": "Radiology, Neuroradiology",
            "state": "CA",
            "license": "A154915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in San Diego, CA

Sources for this page

Verify at the official NPI Registry.