Anthony Bolton, PHD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

0113678 Issued in NY

Practice address

464 Main St
Suite B
Port Jefferson, NY 11777-2814

Phone

(631) 331-4377

Fax

(631) 331-4459

NPI assigned

Mar 29, 2007

Last updated

Jul 17, 2015By the provider in NPPES

Sex

Male

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 NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

0 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

0

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Anthony K Bolton PHD Neuropsychology PC

  • Psychiatry Physician
  • Rocky Point, NY
  • NPI 1689910861
  Medicare reassignment NPD Authorized official
• Port Neurology PC

  • Specialist
  • Port Jefferson, NY
  • NPI 1417024001
  NPD (past)

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

{
    "created_epoch": "1175126400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437091200000",
    "number": "1275653032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "170 ROUTE 25A",
            "city": "ROCKY POINT",
            "state": "NY",
            "postal_code": "117788750",
            "telephone_number": "631-331-4437",
            "fax_number": "631-331-4459"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "464 MAIN ST",
            "address_2": "SUITE B",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772814",
            "telephone_number": "631-331-4377",
            "fax_number": "631-331-4459"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "ANTHONY",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-29",
        "last_updated": "2015-07-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NY",
            "license": "0113678",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Lynn Blydenburgh, D.O.
• BMMG Health Company LLC
• Joseph Peter Boglia, MD
• Stephanie Leigh Bollhofer, PA-C
• Corien Bologna, LCAT, ATR-BC
• Ramyaprabha Bondalapati, MD
• Carol Elizabeth Bonura, NP
• Joanna Rose Bonura, LMHC, CASAC-2
• Edward B Borden, M.D.
• Michael Borrero

• Psychiatry Physician in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Psychiatry Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2015; 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.