NPIMap

Individual provider Active NPI

David Alfonso Bolivar, MD

  • Surgery Physician
  • Templeton, CA
National Provider Identifier
1346242005
Registry record updated Aug 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
A68461 Issued in CA
Practice address
292 Posada LN
Ste C
Templeton, CA 93465-4054
Phone
(805) 434-3133
Fax
(805) 434-3850
NPI assigned
Aug 12, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X A68461 CA Primary

Addresses

Primary practice location

292 Posada LN
Ste C
Templeton, CA 93465-4054

Mailing address

292 Posada LN
Ste C
Templeton, CA 93465-4054
Phone (805) 434-3133

Other identifiers 1

IdentifierTypeStateIssuer
00A684610MedicaidCA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20050216000968 CA Practitioner - General Surgery 2567363278 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Loma Linda University School of Medicine, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Southern Monterey County Memorial HospitalGroup PAC ID 7719883461, 33 clinicians
Associated Surgeons of San Luis ObispoGroup PAC ID 7810949989, 10 clinicians

Practice addresses (Care Compare)

210 Canal St
King City, CA 93930-3432
Phone (931) 385-7100

292 Posada LN
Suite C
Templeton, CA 93465-4054
Phone (805) 434-2253

Hospital & facility affiliations

  • Central Coast Home Health Inc Home health agency, San Luis Obispo, CA, CCN 059010
  • Central Coast Home Health, Inc Hospice, San Luis Obispo, CA, CCN 551604
  • Adventist Health Twin Cities Hospital, Templeton, CA, CCN 050633
  • Adventist Health Sierra Vista Hospital, San Luis Obispo, CA, CCN 050506
  • French Hospital Medical Center Hospital, San Luis Obispo, CA, CCN 050232
  • Marian Regional Medical Center Hospital, Santa Maria, CA, CCN 050107
  • Southern Monterey County Memorial Hospital Hospital, King City, CA, CCN 051336

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

Procedures performed for Medicare patients

ProcedureNumber of procedures
Spinal fusion23
Colonoscopy1-10
Hernia repair - groin (open)30
Hernia repair (minimally invasive)1-10
Mastectomy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Varicose vein removal1-10
Melanoma (skin cancer) excision1-10
Removal of tissue86

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A68461CAMDSurgery Physician

Practice roles (7 of 8)

OrganizationSpecialtyStatusNew patients
Southern Monterey County Memorial Hospital CurrentSince Aug 1, 2024 Accepting new patients
Associated Surgeons of San Luis Obispo Surgery CurrentSince Jul 26, 2002 Accepting new patients
Southern Monterey County Memorial Hospital CurrentSince Aug 1, 2024 Accepting new patients
Posada Ambulatory Surgery Center, LP Current Accepting new patients
Dignity Community Care Past Accepting new patients
Twin Cities Community Hospital, Inc. Past Accepting new patients
Doctors Medical Center of Modesto, Inc. Past Accepting new patients

Locations

210 Canal St
King City, CA 93930
Phone (931) 385-7100

300 Canal St
King City, CA 93930
Phone (831) 385-6000

77 Casa St
Ste 103
Sn Luis Obisp, CA 93405
Phone (805) 544-8993

292 Posada Ln
Ste C
Templeton, CA 93465
Phone (805) 434-2253

Networks

  • BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.1294
  • FHIR API: https://fhir4.healow.com/fhir/r4/JDEGCD

Organizations & group practices 10

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 6

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": "1123804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660608000000",
    "number": "1346242005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "292 POSADA LN",
            "address_2": "STE C",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934654054",
            "telephone_number": "805-434-3133",
            "fax_number": "805-434-3850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "292 POSADA LN",
            "address_2": "STE C",
            "city": "TEMPLETON",
            "state": "CA",
            "postal_code": "934654054",
            "telephone_number": "805-434-3133",
            "fax_number": "805-434-3850"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIVAR",
        "first_name": "DAVID",
        "middle_name": "ALFONSO",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-12",
        "last_updated": "2022-08-16",
        "certification_date": "2022-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CA",
            "license": "A68461",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A684610",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Templeton, CA

Sources for this page

Verify at the official NPI Registry.