Edgar B Bolton Jr., DO

Primary specialty

Pulmonary Disease PhysicianTaxonomy code 207RP1001X

License

OS2458 Issued in FL

Practice address

1900 N University Dr
Suite 107
Pembroke Pines, FL 33024-3618

Phone

(954) 441-1616

Fax

(954) 766-8199

NPI assigned

Nov 8, 2005

Sex

Male

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 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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

Practice roles

Locations

Networks

• Freedom Health HMO Network

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.

• Edgar B Bolton DO PA

  • Pulmonary Disease Physician
  • Fort Lauderdale, FL
  • NPI 1790122778
  NPD Authorized official
• Melvyn H. Rech, D.O., P.a.

  • Orthopaedic Surgery Physician
  • Pembroke Pines, FL
  • NPI 1851654529
  NPD (past)
• Nova Southeastern University, Inc

  • Family Medicine Physician
  • Davie, FL
  • NPI 1447345517
  NPD (past)
• Sunrise Medical Group II LLC

  • Pulmonary Disease Physician
  • Hollywood, FL
  • NPI 1376821595
  NPD (past)

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

{
    "created_epoch": "1131408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455148800000",
    "number": "1487635462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1512 SE 10TH ST",
            "city": "FORT LAUDERDALE",
            "state": "FL",
            "postal_code": "333161420",
            "telephone_number": "954-445-1754",
            "fax_number": "954-766-8199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 N UNIVERSITY DR",
            "address_2": "SUITE 107",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330243618",
            "telephone_number": "954-441-1616",
            "fax_number": "954-766-8199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "EDGAR",
        "middle_name": "B",
        "name_suffix": "Jr.",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-11-08",
        "last_updated": "2016-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "FL",
            "license": "OS2458",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "037708200",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "HF850A",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Yaolen Bolanos, MD
• Debra J. Bolger, LCSW
• Cristina Bolivar, APRN, FNP-C
• Byanca Bolivard, COTA/L
• Augustine A Bollo, DPM
• Charles Bonanno, PHARM. D.
• Sarina Rose Bonanno
• Ricardo Bones
• Marie Bonhomme
• Valerie Bonhomme, PHARMD

• Pulmonary Disease Physician in Pembroke Pines, FL
• Providers in Pembroke Pines, FL by specialty
• Pulmonary Disease Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2016; 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.