Mark Alan Boles, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

9700867 Issued in NC

Practice address

1331 North Elm Street
Suite 200
Greensboro, NC 27401-6304

Phone

(336) 274-9617

Fax

(336) 482-2177

NPI assigned

Oct 28, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 6

Medicare fee-for-service enrollment

Enrolled in NC

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Diagnostic Radiology & Imaging LLC

  • Diagnostic Radiology Physician
  • Greensboro, NC
  • NPI 1265469795

  Diagnostic Radiology, NC

  Medicare reassignment NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Internal Medicine Physician
  • Greensboro, NC
  • NPI 1356372064

  NC

  Medicare reassignment NPD
• Imrad of Virginia PLLC

  • Diagnostic Radiology Physician
  • Woodbridge, VA
  • NPI 1457816522

  Diagnostic Radiology, NC

  Medicare reassignment NPD
• Greensboro Radiology, PA

  • Diagnostic Radiology Physician
  • Greensboro, NC
  • NPI 1821035999

  Diagnostic Radiology

  NPD
• Pinnacle Health Services of North Carolina LLC

  • Radiology Clinic/Center
  • Raleigh, NC
  • NPI 1457300089

  Diagnostic Radiology

  NPD
• Pinnacle Health Services of North Carolina, LLC

  • Radiology Clinic/Center
  • Clayton, NC
  • NPI 1548454127

  Diagnostic Radiology

  NPD
• The Moses H Cone Memorial Hospital Operating Corporation

  • Community/Retail Pharmacy
  • Eden, NC
  • NPI 1861222507
  NPD

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

{
    "created_epoch": "1130457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1235129388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 63112",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282633112",
            "telephone_number": "336-274-9617",
            "fax_number": "336-482-2177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1331 NORTH ELM STREET",
            "address_2": "SUITE 200",
            "city": "GREENSBORO",
            "state": "NC",
            "postal_code": "274016304",
            "telephone_number": "336-274-9617",
            "fax_number": "336-482-2177"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLES",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-28",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "9700867",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "300085676",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "1049U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARTNERS",
            "identifier": "24726",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "891049U",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDCOST",
            "identifier": "70567",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1603211",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ariana Bogwicz, CNM
• Cherie Monet Bohaboy, LCSWA, CADCI
• William R Bohaboy Jr., LCAS-A
• Hayley Marie Boisseau, PAC
• David Michael Boles, DPT
• Sarah Bolis, DMD
• Dione Mitchell Bolton
• Karen Bolyard, P.T.
• Renee S. Bomar, MS/CCC-SLP
• Nicole Carolyn Bomberger

• All providers in Greensboro, NC
• Diagnostic Radiology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.