Jayanth Bolaram, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

S9660 Issued in TX

Practice address

2405 9TH St Ste a
Wichita Falls, TX 76301-4060

Phone

(863) 214-3230

NPI assigned

Aug 31, 2006

Sex

Male

Sole proprietor

No

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 FL, TX2 enrollments

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 2

Specialty

Psychiatry

Education

Other, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cedar Crest ClinicGroup PAC ID 9537063409, 8 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/fhir/r4/
• Direct secure messaging: jbolaram72538@unitedregional.medalliesdirect.net
• Direct secure messaging: jayanth.bolaram.1@24914.direct.athenahealth.com
• FHIR API: https://epicproxy.et1096.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

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.

• Cedar Crest Clinic

  • Mental Health Counselor
  • Belton, TX
  • NPI 1710936380
  Medicare reassignment Care Compare group NPD
• United Regional Physician Group

  • Family Medicine Physician
  • Wichita Falls, TX
  • NPI 1407890775
  Medicare reassignment
• United Regional Health Care System Inc

  • General Acute Care Hospital
  • Wichita Falls, TX
  • NPI 1023013448
  NPD
• Red River Hospital, LLC

  • Psychiatric Hospital
  • Wichita Falls, TX
  • NPI 1427048743
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662940800000",
    "number": "1336251016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2405 9TH ST STE A",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014060",
            "telephone_number": "863-214-3230"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2405 9TH ST STE A",
            "city": "WICHITA FALLS",
            "state": "TX",
            "postal_code": "763014060",
            "telephone_number": "863-214-3230"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLARAM",
        "first_name": "JAYANTH",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2022-09-12",
        "certification_date": "2022-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME92560",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "S9660",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Nicole Bobbitt
• Gerald Bodde, LPT
• Diane Johnson Boddy, LPC
• Megan N Bodine, PHD
• Michael Bohannan, LPC
• Daniel Huffman Bolin, M.D.
• Hiram Jeffrey Bollinger, MPAS, PA-C
• Ivoryne Maude Bollinger
• Donald L Bomer, MD
• Paul Steven Bonner, DDS

• Psychiatry Physician in Wichita Falls, TX
• Providers in Wichita Falls, TX by specialty
• Psychiatry Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 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.