Lucy Bolerjack, DO

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

OS22431 Issued in FL

Practice address

836 Prudential Dr Ste 1202
Jacksonville, FL 32207-8339

Phone

(904) 493-5323

Fax

(866) 554-1605

NPI assigned

May 26, 2021

Sex

Female

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

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 1

Specialty

Obstetrics/Gynecology

Education

Michigan State University College of Human Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Womens Care Florida LLCGroup PAC ID 9234031444, 324 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Medical Center - Jacksonville Hospital, Jacksonville, FL, CCN 100088
• Baptist Medical Center Beaches Hospital, Jacksonville Beach, FL, CCN 100117

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

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.

• Women'S Care Florida LLC

  • Obstetrics & Gynecology Physician
  • Tampa, FL
  • NPI 1013902923
  Medicare reassignment Care Compare group NPD
• Womens' Health Hospitalists, LLC

  • Obstetrics & Gynecology Physician
  • Tampa, FL
  • NPI 1205295599
  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Baptist Medical Center of the Beaches, Inc

  • General Acute Care Hospital
  • Jacksonville Beach, FL
  • NPI 1821155912
  Care Compare affiliation
• Southern Baptist Hospital of Florida Inc

  • General Acute Care Hospital
  • Jacksonville, FL
  • NPI 1578620449
  Care Compare affiliation

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

{
    "created_epoch": "1621987200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1752192000000",
    "number": "1346815875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 748817",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303748817",
            "telephone_number": "813-286-0033",
            "fax_number": "813-282-1806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "836 PRUDENTIAL DR STE 1202",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078339",
            "telephone_number": "904-493-5323",
            "fax_number": "866-554-1605"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 Genesys Pkwy",
            "address_purpose": "LOCATION",
            "city": "Grand Blanc",
            "state": "MI",
            "postal_code": "484398065",
            "country_code": "US",
            "telephone_number": "810-606-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLERJACK",
        "first_name": "LUCY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-26",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MI",
            "license": "5151014839",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "FL",
            "license": "OS22431",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bold City Therapy and Wellness LLC
• Bold Healthcare PLLC
• Tiffany Bolden
• Irina Eugenievna Boldt, M.D.
• Paul R Boldt, D.M.D.
• Kathryn Susanne Boles, D.O.
• Rachel Amanda Bolger, PT, DPT
• William E Bolger, M.D.
• Kylee Waynette Bolibrzuch, MSW
• Laura Stultz Bolinski

• Obstetrics & Gynecology Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Obstetrics & Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; 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.