Jenna Bolger, FNP

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

F06220820 Issued in AZ

Practice address

5757 W Thunderbird Rd Ste W212
Glendale, AZ 85306-5607

Phone

(602) 603-2275

NPI assigned

Jun 20, 2022

Reactivated

Sep 21, 2022

Last updated

Sep 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Nurse Practitioner

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Brian G Lee MD PLLCGroup PAC ID 4082914247, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• Brian G Lee MD PLLC

  • Otolaryngology/Facial Plastic Surgery Physician
  • Scottsdale, AZ
  • NPI 1811365703
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1655683200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663718400000",
    "number": "1265163323",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4202 E CACTUS RD APT 8306",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850327669",
            "telephone_number": "814-381-4662"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5757 W THUNDERBIRD RD STE W212",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853065607",
            "telephone_number": "602-603-2275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLGER",
        "first_name": "JENNA",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-20",
        "last_updated": "2022-09-21",
        "certification_date": "2022-09-21",
        "deactivation_date": "2022-08-02",
        "reactivation_date": "2022-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "AZ",
            "license": "F06220820",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shani Deon Boeh, AAS
• Robert Bofman
• Anne Bojorquez, M.D.
• Librada Bojorquez
• Jonathan Bolesta, DMD
• Patricia Bolivar, LMSW
• Samantha Anne Bollschweiler
• Mary Ann Bolyog, FNP-C
• Bradley Boman, DO
• Elisa Bomgaars, MD

• Adult Medicine Physician in Glendale, AZ
• Providers in Glendale, AZ by specialty
• Adult Medicine Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2022; 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.
• 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.