Individual provider Active NPI

Andrea M Bolesta, PA-C

  • Physician Assistant
  • Exton, PA
National Provider Identifier
1467733816
Registry record updated Jan 5, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
MA055091 Issued in PA
Practice address
111 Arrandale Blvd
Exton, PA 19341-2503
Phone
(610) 363-2532
NPI assigned
Aug 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 25MP00265400 NJ
Physician Assistant 363A00000X MA055091 PA Primary

Addresses

Primary practice location

111 Arrandale Blvd
Exton, PA 19341-2503

Mailing address

1296 Grove Rd
West Chester, PA 19380-1062
Phone (610) 585-0192

Other practice location 1

509 N Broad St
Woodbury, NJ 08096-1617
Phone (856) 845-0100

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, PA2 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

Enrollment IDStateProvider typePAC IDDetails
I20130312000550 NJ Practitioner - Physician Assistant 7214182559 Reassigns benefits to 1 organization
I20201231000262 PA Practitioner - Physician Assistant 7214182559 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Associates of Chester CountyGroup PAC ID 9234113572, 16 clinicians

Practice addresses (Care Compare)

111 Arrandale Blvd
Exton, PA 19341-2503
Phone (610) 363-2532

200 Willowbrook LN
Suite 240
West Chester, PA 19382-5697
Phone (610) 363-2532

Hospital & facility affiliations

  • Chester County Hospital Hospital, West Chester, PA, CCN 390179

Merit-based Incentive Payment System (MIPS)

Final score
92.91 of 100Reported as group
Quality
100
Improvement activities
40
Cost
76.35

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
MA055091PAMDPhysician Assistant
25MP00265400NJMDMedical Physician Assistant

Organizations & group practices 3

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672876800000",
    "number": "1467733816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1296 GROVE RD",
            "city": "WEST CHESTER",
            "state": "PA",
            "postal_code": "193801062",
            "telephone_number": "610-585-0192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 ARRANDALE BLVD",
            "city": "EXTON",
            "state": "PA",
            "postal_code": "193412503",
            "telephone_number": "610-363-2532"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "509 N Broad St",
            "address_purpose": "LOCATION",
            "city": "Woodbury",
            "state": "NJ",
            "postal_code": "080961617",
            "country_code": "US",
            "telephone_number": "856-845-0100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLESTA",
        "first_name": "ANDREA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2023-01-05",
        "certification_date": "2023-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NJ",
            "license": "25MP00265400",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "PA",
            "license": "MA055091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Exton, PA

Sources for this page

Verify at the official NPI Registry.