Mary-Ann Priscilla Bolte, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

24128 Issued in WA

Practice address

2105 112TH Ave NE
Suite 200
Bellevue, WA 98004-2945

Phone

(425) 452-2964

NPI assigned

Sep 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in WA

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

Psychiatry

Education

University of Washington School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Navos

  • Psychiatric Hospital
  • Seattle, WA
  • NPI 1124034699
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294617600000",
    "number": "1407954472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2105 112TH AVE NE",
            "address_2": "SUITE 200",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98004",
            "telephone_number": "425-452-2964"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2105 112TH AVE NE",
            "address_2": "SUITE 200",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "980042945",
            "telephone_number": "425-452-2964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTE",
        "first_name": "MARY-ANN",
        "middle_name": "PRISCILLA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-21",
        "last_updated": "2011-01-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "WA",
            "license": "24128",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8114167",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUESHIELD PIN",
            "identifier": "BO4573",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kodey Christine Bolander
• Brigitta Michiko Bolanos, LMP
• Ryan Griffin Bolding, CB61032862
• Angela Bolen, BS
• Chelsey Bollinger
• Brett D Bolton, D.C.
• Lisa Michelle Bolton, A.P.N.
• Alicia K Bomer
• Maria Bonamer, PHARMD
• Amanda Bond

• Psychiatry Physician in Bellevue, WA
• Providers in Bellevue, WA by specialty
• Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2011; 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.