Derek Bolalin, CRNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

R237327 Issued in MD

Practice address

826 Washington Rd Ste 110a
Westminster, MD 21157-5779

Phone

(619) 252-1730

NPI assigned

Apr 21, 2023

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 MD

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

U N I Medical Care Inc 21 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• U N I Medical Care Inc

  • Urgent Care Clinic/Center
  • Westminster, MD
  • NPI 1790962371

  MD

  Medicare reassignment Care Compare group NPD
• Baymark Health Services of West Virginia, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Morgantown, WV
  • NPI 1174062731
  NPD
• U.N.I. Medical Care, Inc

  • Urgent Care Clinic/Center
  • Clarksville, MD
  • NPI 1760837686
  NPD (past)

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

{
    "created_epoch": "1682035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690070400000",
    "number": "1326735002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "826 WASHINGTON RD STE 110A",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575779",
            "telephone_number": "619-252-1730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "826 WASHINGTON RD STE 110A",
            "city": "WESTMINSTER",
            "state": "MD",
            "postal_code": "211575779",
            "telephone_number": "619-252-1730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLALIN",
        "first_name": "DEREK",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-04-21",
        "last_updated": "2023-07-23",
        "certification_date": "2023-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MD",
            "license": "R237327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Board of Carroll County Commissioners
• Bonnie Bock, CRNP
• Sandra Ann Boehm, PHARMD
• Alexander Bogdaschewskyi, M.D.
• Diane Marie Bohn, P.T.
• Mark Bolitiski
• Carol Bolles, MA
• Aruna Bollineni, MD
• Mary Susan Bollinger, M.D.
• Bassam Y Borakat, MD

• All providers in Westminster, MD
• Family Nurse Practitioner in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2023; 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.