Kelly Michelle Bolden, MD

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

MD040080 Issued in DC

Practice address

5301 Wisconsin Ave NW Ste 100
Washington, DC 20015-2070

Phone

(202) 237-9292

NPI assigned

Dec 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

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

Specialty

General Surgery

Education

Baylor College of Medicine, 2003

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Howard UniversityGroup PAC ID 0941109565, 182 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kellybolden@hufp.allscriptsdirect.net

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.

• Howard University

  • Multi-Specialty Clinic/Center
  • Washington, DC
  • NPI 1033163597
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589414400000",
    "number": "1265616007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4834 BLAGDEN AVE NW",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200113716",
            "telephone_number": "202-230-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5301 WISCONSIN AVE NW STE 100",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200152070",
            "telephone_number": "202-237-9292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2041 Georgia Ave NW Tower 4000",
            "address_purpose": "LOCATION",
            "city": "Washington",
            "state": "DC",
            "postal_code": "200603076",
            "country_code": "US",
            "telephone_number": "202-865-3785",
            "fax_number": "202-865-3131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLDEN",
        "first_name": "KELLY",
        "middle_name": "MICHELLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2020-05-14",
        "certification_date": "2020-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "MD",
            "license": "D0071243",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "DC",
            "license": "MD040080",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surajudeen Adebola Bolarinwa, M.D.
• Bold Expressions Therapy
• Bold Move Integrative Wellness
• Fern Bolden
• Gary Bolden, R.K.T.
• Sean Bolden
• Tess Bolder, LGSW
• Darnell Bolding
• Latoya Trenise Bolds-Johnson, PA-C
• Erick Boldt, DO

• Plastic Surgery Physician in Washington, DC
• Providers in Washington, DC by specialty
• Plastic Surgery Physician in District of Columbia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2020; 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.