Individual provider Active NPI

Bolivar Contreras Mora, M.D.

  • Internal Medicine Physician
  • Washington, DC
National Provider Identifier
1205217734
Registry record updated Nov 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
35.133046 Issued in OH
Practice address
1150 Varnum St NE
Washington, DC 20017-2104
Phone
(202) 269-7747
NPI assigned
Jun 10, 2015
Last updated
Nov 17, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 17, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 35.133046 OH Primary

Addresses

Primary practice location

1150 Varnum St NE
Washington, DC 20017-2104

Mailing address

808 W Broad St
Falls Church, VA 22046-3106
Phone (703) 945-7941

Other practice location 1

1 Wyoming St Ste Se3100B
Dayton, OH 45409-2722
Phone (937) 208-8394

Other practice location 2

1 Medical Center Dr
Middletown, OH 45005-2584
Phone (513) 974-2111

Other practice location 3

3130 N County Road 25A
Troy, OH 45373-1337
Phone (937) 440-4466

Other practice location 4

2400 Miami Valley Dr
Centerville, OH 45459-4774
Phone (937) 208-8394

Other practice location 5

9000 N Main St
Englewood, OH 45415-1180
Phone (937) 208-8394

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180710001154 OH Practitioner - Internal MedicinePractitioner - Hospitalist 7618223413 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hisey Physician Services, LLCGroup PAC ID 8426495292, 43 clinicians
Upper Valley Professional CorporationGroup PAC ID 5597658138, 83 clinicians

Practice addresses (Care Compare)

1 Medical Ctr Dr
Middletown, OH 45005-2584
Phone (513) 974-2111

3130 N Country Rd
25A
Troy, OH 45373-1337
Phone (937) 440-4466

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.83 of 100Reported as group
Quality
78.11
Improvement activities
40
Cost
74.76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.133046OHMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mvhe, Inc Internal Medicine CurrentSince Sep 14, 2025 Accepting new patients
Knox Community Hospital CurrentSince Jul 24, 2025 Accepting new patients
Hisey Physician Services, LLC Internal Medicine CurrentSince Jun 30, 2025 Accepting new patients
Knox Community Hospital Current Accepting new patients
Knox Community Hospital Current Accepting new patients
Knox Community Hospital CurrentSince Jul 24, 2025 Accepting new patients
Upper Valley Professional Corporation Internal Medicine CurrentSince Sep 14, 2025 Accepting new patients
Apogee Medical Group Ohio Inc Internal Medicine CurrentSince Jun 25, 2018 Accepting new patients
Mvhe Inc Internal Medicine CurrentSince Sep 14, 2025 Accepting new patients
Mvhe Inc Internal Medicine Current Accepting new patients
Knox Community Hospital Current Accepting new patients
Upper Valley Medical Center Past Accepting new patients
Adena Health System Past Accepting new patients

Locations

200 Corporate Blvd
Lafayette, LA 70508

722 N Fairfield Rd
Beavercreek, OH 45434
Phone (937) 208-7000

272 Hospital Rd
Chillicothe, OH 45601
Phone (740) 779-4275

1 Wyoming St
Ste SE3100B
Dayton, OH 45409
Phone (937) 208-8394

161 Wyoming St
Dayton, OH 45409
Phone (937) 208-0880

2400 Miami Valley Dr
Dayton, OH 45459
Phone (937) 208-8394

2451 Wayne Ave
Dayton, OH 45420
Phone (937) 252-1831

9000 N Main St
Englewood, OH 45415
Phone (937) 208-8394

550 Mirabeau St
Greenfield, OH 45123
Phone (937) 672-4128

1 Medical Center Dr
Middletown, OH 45005
Phone (513) 424-2111

1330 Coshocton Ave
Mount Vernon, OH 43050
Phone (740) 393-9019

1805 27th St
Portsmouth, OH 45662
Phone (740) 356-5000

450 N Hyatt St
Ste 202
Tipp City, OH 45371
Phone (937) 667-3141

3130 N County Road 25A
Troy, OH 45373
Phone (937) 440-4000

100 Dawn Ln
Waverly, OH 45690
Phone (740) 947-2186

Interoperability endpoints

  • Direct secure messaging: bcontrerasmora1073460@direct.osumc.edu

Organizations & group practices 13

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.

View all 13

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": "1433894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763337600000",
    "number": "1205217734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 W BROAD ST",
            "city": "FALLS CHURCH",
            "state": "VA",
            "postal_code": "220463106",
            "telephone_number": "703-945-7941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 VARNUM ST NE",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200172104",
            "telephone_number": "202-269-7747"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Wyoming St Ste Se3100B",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454092722",
            "country_code": "US",
            "telephone_number": "937-208-8394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Middletown",
            "state": "OH",
            "postal_code": "450052584",
            "country_code": "US",
            "telephone_number": "513-974-2111",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3130 N County Road 25A",
            "address_purpose": "LOCATION",
            "city": "Troy",
            "state": "OH",
            "postal_code": "453731337",
            "country_code": "US",
            "telephone_number": "937-440-4466",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2400 Miami Valley Dr",
            "address_purpose": "LOCATION",
            "city": "Centerville",
            "state": "OH",
            "postal_code": "454594774",
            "country_code": "US",
            "telephone_number": "937-208-8394",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9000 N Main St",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "454151180",
            "country_code": "US",
            "telephone_number": "937-208-8394",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CONTRERAS MORA",
        "first_name": "BOLIVAR",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-10",
        "last_updated": "2025-11-17",
        "certification_date": "2025-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "OH",
            "license": "35.133046",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.