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Individual provider Active NPI

Martin A Bolic, M.D.

  • Internal Medicine Physician
  • Rockville Centre, NY
National Provider Identifier
1275566747
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
197717-1 Issued in NY
Practice address
2 Lincoln Ave
Suite 201
Rockville Centre, NY 11570-5775
Phone
(516) 536-0600
Fax
(516) 536-0694
NPI assigned
Jul 8, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 197717-1 NY Primary

Addresses

Primary practice location

2 Lincoln Ave
Suite 201
Rockville Centre, NY 11570-5775

Mailing address

2 Lincoln Ave
Suite 201
Rockville Centre, NY 11570-5775
Phone (516) 536-0600

Other identifiers 3

IdentifierTypeStateIssuer
P381679OtherNYOXFORD HEALTH PLANS
761881OtherNYEMPIRE BCBS
1376740OtherNYUNITED HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100201000041 NY Practitioner - Internal Medicine 1355413071 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Albany Medical College of Union University, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Optum Medical Care PCGroup PAC ID 9931013240, 1,013 clinicians

Practice addresses (Care Compare)

90 S Bedford Rd
Mount Kisco, NY 10549-3412
Phone (914) 241-1050

Hospital & facility affiliations

  • Mt. Sinai at Home Home health agency, Westbury, NY, CCN 337246
  • Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
  • Emerest Home Health Care of Long Island Home health agency, Flushing, NY, CCN 337189
  • NYU Langone Home Health Care Home health agency, Garden City, NY, CCN 337187
  • Mercy Medical Center Hospital, Rockville Centre, NY, CCN 330259
  • North Shore University Hospital Hospital, Manhasset, NY, CCN 330106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
197717-1NYMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Optum Medical Care, P.C. CurrentSince Sep 1, 2022 Accepting new patients
Mount Kisco Medical Group Past Accepting new patients

Locations

111 Bedford Rd
Katonah, NY 10536
Phone (914) 232-3135

90 S Bedford Rd
Mount Kisco, NY 10549
Phone (914) 242-1050

110 S Bedford Rd
Mount Kisco, NY 10549
Phone (763) 910-9192

Philadelphia, PA 19195

Organizations & group practices 3

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.

Hospital & facility affiliations 8

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1152316800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1275566747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 LINCOLN AVE",
            "address_2": "SUITE 201",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705775",
            "telephone_number": "516-536-0600",
            "fax_number": "516-536-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 LINCOLN AVE",
            "address_2": "SUITE 201",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115705775",
            "telephone_number": "516-536-0600",
            "fax_number": "516-536-0694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIC",
        "first_name": "MARTIN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "197717-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD HEALTH PLANS",
            "identifier": "P381679",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE BCBS",
            "identifier": "761881",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1376740",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville Centre, NY

Sources for this page

Verify at the official NPI Registry.