Alyssa Marie Bolter, MS, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA55847 Issued in CA

Practice address

1625 Schrader Blvd
Los Angeles, CA 90028

Phone

(323) 993-7500

NPI assigned

Aug 13, 2018

Last updated

Jul 1, 2024By the provider in NPPES

Sex

Female

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, NC2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science, Physician Assistant

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: abolter604009@direct.ochin.org

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.

• Los Angeles LGBT Center

  • Federally Qualified Health Center (FQHC)
  • Los Angeles, CA
  • NPI 1548298532
  Medicare reassignment
• Western North Carolina Community Health Services Inc.

  • Federally Qualified Health Center (FQHC)
  • Asheville, NC
  • NPI 1780801050
  Medicare reassignment
• Western North Carolina Community Health Services, Inc.

  • Community Health Clinic/Center
  • Asheville, NC
  • NPI 1043392921
  NPD
• Western North Carolina Community Health Services, Inc.

  • Federally Qualified Health Center (FQHC)
  • Marion, NC
  • NPI 1790402345
  NPD

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

{
    "created_epoch": "1534118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719792000000",
    "number": "1457830150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900286213",
            "telephone_number": "323-993-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1625 SCHRADER BLVD",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "90028",
            "telephone_number": "323-993-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTER",
        "first_name": "ALYSSA",
        "middle_name": "MARIE",
        "credential": "MS, PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-13",
        "last_updated": "2024-07-01",
        "certification_date": "2024-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA55847",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Veronica Bolotnikova
• Nina Bolour
• Pejman Bolourian, MD
• Agnes Bolt, PMHNP, RN
• Elisabeth Renee Bolten, OTR/L
• Deborah Bolton, NP
• Masai Bolton
• Lucie Bolzan
• Bomamed Inc
• Cynthia Bomaster

• Physician Assistant in Los Angeles, CA
• Providers in Los Angeles, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.