Active NPI
Jennifer Connolly Boldrick, MD
- Dermatology Physician
- Stanford, CA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Dermatology Physician
- License
- A88543
- Practice address
- 300 Pasteur Dr
Stanford, CA 94305-2200 - Phone
- (650) 723-4000
- NPI assigned
- May 1, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Dermatology Physician | 207N00000X | A88543 | CA | Primary |
Addresses
Primary practice location
300 Pasteur Dr
Stanford, CA 94305-2200
Mailing address
325 Distel Cir
Los Altos, CA 94022-1408
Phone (650) 596-4160
Other practice location 1
301 Industrial Rd
San Carlos, CA 94070-2603
Phone (650) 596-4160
Medicare participation
Medicare enrollment files- 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: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Dermatology
- Education
- Stanford University School of Medicine, 2003
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
123 S San Mateo Dr
San Mateo, CA 94401-3804
Phone (650) 343-4200
1720 El Camino Real
Burlingame, CA 94010-3225
300 Pasteur Dr
Stanford, CA 94305-2200
Phone (650) 723-4000
301 Industrial Rd
San Carlos, CA 94070-2603
Phone (415) 600-1000
795 El Camino Real
Palo Alto, CA 94301-2302
Phone (415) 600-1020
Hospital & facility affiliations
- Stanford Health Care
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of skin lesions | 1057 |
| Skin biopsy | 145 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| A88543 | CA | MD | Dermatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Stanford Health Care | Current | Accepting new patients | |
| Stanford Health Care | Dermatology | Current | Accepting new patients |
| Sutter Bay Medical Foundation | Current | Accepting new patients | |
| Sutter East Bay Medical Foundation | Past | Accepting new patients | |
| Sequoia Health Services | Past | Accepting new patients | |
| Lucile Salter Packard Children'S Hospital at Stanford | Past | Accepting new patients |
Locations
1950 University Ave
Ste 160
East Palo Alto, CA 94303
Phone (650) 317-8100
3200 Kearney St
Fremont, CA 94538
Phone (510) 498-2800
325 Distel Cir
Los Altos, CA 94022
Phone (510) 204-3977
370 Distel Cir
Los Altos, CA 94022
Phone (650) 254-5200
2350 W El Camino Real
Fl 2
Mountain View, CA 94040
Phone (650) 691-6174
795 El Camino Real
Palo Alto, CA 94301
Phone (650) 324-1832
900 Blake Wilbur Dr
Palo Alto, CA 94304
Phone (650) 498-6004
795 El Camino Real
#1112
Palo Alto, CA 94301
3250 Alpine Rd
Portola Vally, CA 94028
Phone (650) 498-9000
290 Redwood Shores Pkwy
Redwood City, CA 94065
Phone (650) 598-3160
151 N Sunrise Ave
Ste 1205
Roseville, CA 95661
Phone (916) 789-1505
301 Industrial Rd
San Carlos, CA 94070
Phone (650) 596-4000
3838 California St
Rm 410
San Francisco, CA 94118
Phone (415) 751-1847
123 S San Mateo Dr
San Mateo, CA 94401
Phone (650) 343-4200
2128 Soquel Ave
Santa Cruz, CA 95062
Phone (831) 425-0727
3883 Airway Dr
Ste 220
Santa Rosa, CA 95403
Phone (707) 521-7750
300 Pasteur Dr
Stanford, CA 94305
Phone (650) 498-5710
550 S Green Valley Rd
Watsonville, CA 95076
Phone (831) 458-5865
Interoperability endpoints
- jboldrick39635@direct.stanfordhealthcare.org
- jboldrickmd20218@hisp.ehr.sutterhealth.org
Organizations & group practices 7
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.
-
- Multi-Specialty Clinic/Center
- Palo Alto, CA
- NPI 1013950807
-
- Specialty Pharmacy
- Mountain View, CA
- NPI 1760366132
-
- Clinical Medical Laboratory
- Santa Clara, CA
- NPI 1669287033
-
- Children's Hospital
- Palo Alto, CA
- NPI 1467442749
-
- General Acute Care Hospital
- Redwood City, CA
- NPI 1235172057
-
- Family Medicine Physician
- Orinda, CA
- NPI 1871538769
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Emeryville, CA
- NPI 1275076325
-
- General Acute Care Hospital
- Emeryville, CA
- NPI 1285177337
-
- General Acute Care Hospital
- Stanford, CA
- NPI 1437292927
-
- General Acute Care Hospital
- Pleasanton, CA
- NPI 1467990465
-
- General Acute Care Hospital
- Stanford, CA
- NPI 1871543215
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1177977600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1713225600000",
"number": "1396966149",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 DISTEL CIR",
"city": "LOS ALTOS",
"state": "CA",
"postal_code": "940221408",
"telephone_number": "650-596-4160"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "300 PASTEUR DR",
"city": "STANFORD",
"state": "CA",
"postal_code": "943052200",
"telephone_number": "650-723-4000"
}
],
"practiceLocations": [
{
"address_1": "301 Industrial Rd",
"address_purpose": "LOCATION",
"city": "San Carlos",
"state": "CA",
"postal_code": "940702603",
"country_code": "US",
"telephone_number": "650-596-4160",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOLDRICK",
"first_name": "JENNIFER",
"middle_name": "CONNOLLY",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-01",
"last_updated": "2024-04-16",
"certification_date": "2024-04-16",
"status": "A"
},
"taxonomies": [
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "CA",
"license": "A88543",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Stanford, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.