Active NPI
Jaja Bolden
- Massage Therapist
- Brooklyn, NY
National Provider Identifier
1225736465
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 028349
- Practice address
- 232 Varet St
Brooklyn, NY 11206-3862 - Phone
- (347) 670-4913
- NPI assigned
- Feb 17, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 028349 | NY | Primary |
Addresses
Primary practice location
232 Varet St
Brooklyn, NY 11206-3862
Mailing address
512 W 156TH St Apt 31
New York, NY 10032-7837
Phone (347) 670-4913
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 028349 | NY | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1676592000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1676592000000",
"number": "1225736465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "512 W 156TH ST APT 31",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100327837",
"telephone_number": "347-670-4913"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "232 VARET ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112063862",
"telephone_number": "347-670-4913"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLDEN",
"first_name": "JAJA",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-02-17",
"last_updated": "2023-02-17",
"certification_date": "2023-02-17",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Massage Therapist",
"state": "NY",
"license": "028349",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 17, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.