Individual provider Active NPI

Barbara A Boldt, PA

  • Medical Physician Assistant
  • Carroll, IA
National Provider Identifier
1215934138
Registry record updated Jun 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
000745 Issued in IA
Practice address
515 N Main St
Carroll, IA 51401
Phone
(712) 792-4000
NPI assigned
Jul 7, 2005
Last updated
Jun 22, 2011By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 000745 IA Primary

Addresses

Primary practice location

515 N Main St
Carroll, IA 51401

Mailing address

515 N Main St
Carroll, IA 51401
Phone (712) 792-4000

Other identifiers 1

IdentifierTypeStateIssuer
P00347793OtherIARR MEDICARE

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20060616000243 IA Practitioner - Physician Assistant 3577575364 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
77.64 of 100Reported as group
Quality
69.74
Promoting interoperability
83
Improvement activities
40
Cost
69.88

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
00745IAMDOccupational Therapist
000745IAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St Anthony Regional Hospital and Nursing Home Current Accepting new patients

Locations

311 S Clark St
Carroll, IA 51401
Phone (712) 792-3581

405 S Clark St
Ste 100
Carroll, IA 51401
Phone (712) 792-1500

Interoperability endpoints

  • Direct secure messaging: baboldt@direct.sarh.kobledirect.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": "1120694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1308700800000",
    "number": "1215934138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "515 N MAIN ST",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "51401",
            "telephone_number": "712-792-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 N MAIN ST",
            "city": "CARROLL",
            "state": "IA",
            "postal_code": "51401",
            "telephone_number": "712-792-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDT",
        "first_name": "BARBARA",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-07-07",
        "last_updated": "2011-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "IA",
            "license": "000745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00347793",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Carroll, IA

Sources for this page

Verify at the official NPI Registry.