Individual provider Active NPI

Daniel Keegan Bolger, MPT

  • Physical Therapist
  • Cincinnati, OH
National Provider Identifier
1205029246
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT-013060 Issued in OH
Practice address
500 E Business Way
Suite C
Cincinnati, OH 45241-2374
Phone
(513) 389-3666
Fax
(513) 389-3665
NPI assigned
Aug 23, 2007
Last updated
Oct 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT-013060 OH Primary

Addresses

Primary practice location

500 E Business Way
Suite C
Cincinnati, OH 45241-2374

Mailing address

6480 Harrison Ave
Suite 201
Cincinnati, OH 45247-7961
Phone (513) 354-7650

Other identifiers 1

IdentifierTypeStateIssuer
000000725621OtherOHANTHEM

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110926000517 OH Practitioner - Physical Therapist in Private Practice 2769653633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Saint Louis University School of Medicine, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

500 E Business Way
Cincinnati, OH 45241-2374
Phone (513) 251-7827

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-013060OHMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Beacon Orthopaedics & Sports Medicine LTD CurrentSince Jul 11, 2011 Accepting new patients
Beacon Orthopaedics & Sports Medicine, LTD Physical Therapist CurrentSince Jul 11, 2011 Accepting new patients

Locations

500 E Business Way
Ste C
Cincinnati, OH 45241
Phone (513) 389-3666

6480 Harrison Ave
Ste 201
Cincinnati, OH 45247
Phone (513) 354-7650

6480 Harrison Ave
Cincinnati, OH 45247
Phone (513) 251-7827

6480 Harrison Ave
Ste 202
Cincinnati, OH 45247
Phone (513) 354-7777

500 E Business Way
Sharonville, OH 45241
Phone (513) 251-7827

Interoperability endpoints

  • Direct secure messaging: daniel.bolger.p1@direct.beaconortho.nextgenshare.com

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1187827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1205029246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 HARRISON AVE",
            "address_2": "SUITE 201",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452477961",
            "telephone_number": "513-354-7650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E BUSINESS WAY",
            "address_2": "SUITE C",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452412374",
            "telephone_number": "513-389-3666",
            "fax_number": "513-389-3665"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLGER",
        "first_name": "DANIEL",
        "middle_name": "KEEGAN",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-23",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OH",
            "license": "PT-013060",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000725621",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cincinnati, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.