Individual provider Active NPI

George Bolotin, M.D.

  • Vascular Surgery Physician
  • Bedford Hills, NY
National Provider Identifier
1215299524
Registry record updated May 10, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Vascular Surgery PhysicianTaxonomy code 2086S0129X
License
297341 Issued in NY
Practice address
52 Main St
Bedford Hills, NY 10507-1814
Phone
(914) 666-2220
NPI assigned
Jun 12, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 10, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Vascular & Interventional Radiology Physician 2085R0204X 01078511A IN
Vascular Surgery Physician 2086S0129X 297341 NY Primary

Addresses

Primary practice location

52 Main St
Bedford Hills, NY 10507-1814

Mailing address

52 Main St
Bedford Hills, NY 10507-1814
Phone (914) 666-2220

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190624000213 NY Practitioner - Interventional RadiologyPractitioner - Diagnostic Radiology 9931478302 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Interventional RadiologyAlso: Diagnostic Radiology
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Total Care Radiology PCGroup PAC ID 3971913740, 5 clinicians

Practice addresses (Care Compare)

4209 Ave U
Brooklyn, NY 11234-5121
Phone (646) 620-5828

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Varicose vein removal586
Leg revascularization (restoring blood flow)76

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01078511AINMDVascular & Interventional Radiology Physician
297341NYMDVascular Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Total Care Radiology PC CurrentSince Sep 1, 2020 Accepting new patients

Locations

869 E Tremont Ave
Bronx, NY 10460
Phone (718) 299-3456

1629 Sheepshead Bay Rd
Ste 2
Brooklyn, NY 11235

2844 Ocean Pkwy
Ste 6
Brooklyn, NY 11235
Phone (718) 942-4047

4209 Avenue U
#A
Brooklyn, NY 11234

4209 Avenue U
Brooklyn, NY 11234
Phone (347) 934-9068

1409 Gravesend Neck Rd
Brooklyn, NY 11229
Phone (718) 332-7771

2752 Ocean Ave
Brooklyn, NY 11229
Phone (718) 484-8765

Networks

  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359

Interoperability endpoints

  • Direct secure messaging: gbolotin4755974@nychhc.direct-ci.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 and National Provider Directory roles.

Hospital & facility affiliations 1

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": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1215299524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 MAIN ST",
            "city": "BEDFORD HILLS",
            "state": "NY",
            "postal_code": "105071814",
            "telephone_number": "914-666-2220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "52 MAIN ST",
            "city": "BEDFORD HILLS",
            "state": "NY",
            "postal_code": "105071814",
            "telephone_number": "914-666-2220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLOTIN",
        "first_name": "GEORGE",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0204X",
            "taxonomy_group": "",
            "desc": "Radiology, Vascular & Interventional Radiology",
            "state": "IN",
            "license": "01078511A",
            "primary": false
        },
        {
            "code": "2086S0129X",
            "taxonomy_group": "",
            "desc": "Surgery, Vascular Surgery",
            "state": "NY",
            "license": "297341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bedford Hills, NY

Sources for this page

Verify at the official NPI Registry.