Michael Scott Bold, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

COR905 Issued in CA

Practice address

2628 San Miguel Dr
Newport Beach, CA 92660-5437

Phone

(949) 644-0165

Fax

(949) 644-7762

NPI assigned

Sep 21, 2006

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 CA

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Michael S Bold OD Inc

  • Optometrist
  • La Palma, CA
  • NPI 1740597269
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1536796800000",
    "number": "1346349909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5422 LA PALMA AVE",
            "city": "LA PALMA",
            "state": "CA",
            "postal_code": "906231705",
            "telephone_number": "714-995-1144",
            "fax_number": "714-995-7979"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2628 SAN MIGUEL DR",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926605437",
            "telephone_number": "949-644-0165",
            "fax_number": "949-644-7762"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5422 La Palma Ave",
            "address_purpose": "LOCATION",
            "city": "LA Palma",
            "state": "CA",
            "postal_code": "906231705",
            "country_code": "US",
            "telephone_number": "714-995-1144",
            "fax_number": "714-995-7979",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLD",
        "first_name": "MICHAEL",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2018-09-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "COR905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Bohning, RNP
• Lana Boladian, PA-C
• Andre Dwight Bolanos
• Cassandra Bolanos
• Jose Bolanos
• Elizabeth Bolduc, RD
• Susan A Bollinger, DDS
• Cindy Bollman, PH.D.
• Talia Bombola, LMFT
• Monica Bonakdar, MD

• Optometrist in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2018; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.