NPIMap

Organization Active NPI

Bold Health Medical Group, a Professional Corporation

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Encinitas, CA
National Provider Identifier
1245749688
Registry record updated Mar 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
BOLD HEALTH MEDICAL GROUP, A PROFESSIONAL CORPORATION
Practice address
561 Saxony PL Ste 101
Encinitas, CA 92024-7700
Phone
(760) 503-5703
NPI assigned
Sep 28, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2025

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

Authorized official

Name
Kathryn Papier Hirst, MDNPI 1053452664
Title
Chief Medical Officer
Phone
(760) 503-4703

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Multi-Specialty Clinic/Center 261QM1300X
Substance Use Disorder Rehabilitation Clinic/Center 261QR0405X

Addresses

Primary practice location

561 Saxony PL Ste 101
Encinitas, CA 92024-7700

Mailing address

561 Saxony PL Ste 101
Encinitas, CA 92024-7700

Other practice location 1

617 Saxony Pl Ste 103
Encinitas, CA 92024-2797
Phone (760) 503-4703

Other names 2

  • Bold Health Doing business as
  • Bold Health Medical Group Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210627000037 CA Part B Supplier - Clinic/Group Practice 9638570716 Receives reassigned benefits from 13 practitioners
Practice locations: Encinitas, CA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
05D2137485Bold Health Medical Group561 Saxony Place Ste 101, Encinitas, CA 92024Certificate of waiverSep 26, 2027
05D2320456Bold Health Medical Group, East Office617 Saxony Place, Ste 103, Encinitas, CA 92024Certificate of waiverMar 17, 2027

National Provider Directory

National Provider Directory

Locations

561 Saxony Pl
Ste 101
Encinitas, CA 92024
Phone (760) 503-4703

Practitioners & affiliated clinicians

Practitioners 29

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1506556800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1742342400000",
    "number": "1245749688",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "561 SAXONY PL STE 101",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920247700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "561 SAXONY PL STE 101",
            "city": "ENCINITAS",
            "state": "CA",
            "postal_code": "920247700",
            "telephone_number": "760-503-5703"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "617 Saxony Pl Ste 103",
            "address_purpose": "LOCATION",
            "city": "Encinitas",
            "state": "CA",
            "postal_code": "920242797",
            "country_code": "US",
            "telephone_number": "760-503-4703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BOLD HEALTH MEDICAL GROUP, A PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-28",
        "last_updated": "2025-03-19",
        "certification_date": "2025-03-19",
        "status": "A",
        "authorized_official_last_name": "HIRST",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_middle_name": "PAPIER",
        "authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
        "authorized_official_telephone_number": "760-503-4703",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bold Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bold Health Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Encinitas, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 19, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.