NPIMap

Individual provider Active NPI

Jorge Mario Bolivar, APRN

  • Acute Care Nurse Practitioner
  • Doral, FL
National Provider Identifier
1588327431
Registry record updated Mar 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
11016043 Issued in FL
Practice address
2801 NW 79TH Ave
Doral, FL 33122-1174
Phone
(786) 466-1000
NPI assigned
Oct 18, 2021
Last updated
Mar 25, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 11016043 FL
Critical Care Medicine Nurse Practitioner 363LC0200X 11016043 FL
Acute Care Nurse Practitioner 363LA2100X 11016043 FL Primary

Addresses

Primary practice location

2801 NW 79TH Ave
Doral, FL 33122-1174

Mailing address

2801 NW 79TH Ave
Doral, FL 33122-1174
Phone (786) 466-1000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231024000040 FL Practitioner - Nurse Practitioner 2567818891 Reassigns benefits to 1 organization
Practice locations: Miami, FL

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of MiamiGroup PAC ID 3274795109, 2,346 clinicians

Practice addresses (Care Compare)

1475 NW 12TH Ave
Miami, FL 33136-1002
Phone (305) 689-8648

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
87.93 of 100Reported as group
Quality
78.79
Promoting interoperability
100
Improvement activities
40
Cost
71.44

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
11016043FLMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University of Miami CurrentSince Apr 23, 2024 Accepting new patients
University of Miami Nurse Practitioner CurrentSince Apr 23, 2024 Accepting new patients
University of Miami Current Accepting new patients
University of Miami Past Accepting new patients

Locations

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

2801 NW 79th Ave
Miami, FL 33122
Phone (786) 466-1000

1801 NW 9th Ave
Fl 6
Miami, FL 33136
Phone (305) 355-5006

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

1475 NW 12th Ave
Miami, FL 33136
Phone (305) 243-4200

1150 NW 14th St
Ste 502
Miami, FL 33136
Phone (305) 243-7429

9333 SW 152nd St
Palmetto Bay, FL 33157
Phone (305) 251-2500

Networks

  • Freedom Health HMO Network
  • Optimum HealthCare HMO Network

Interoperability endpoints

  • Direct secure messaging: jbolivar137755@direct.med.miami.edu

Organizations & group practices 4

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.

Hospital & facility affiliations 23

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

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1634515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711324800000",
    "number": "1588327431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 NW 79TH AVE",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221174",
            "telephone_number": "786-466-1000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 NW 79TH AVE",
            "city": "DORAL",
            "state": "FL",
            "postal_code": "331221174",
            "telephone_number": "786-466-1000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIVAR",
        "first_name": "JORGE",
        "middle_name": "MARIO",
        "name_prefix": "Mr.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-10-18",
        "last_updated": "2024-03-25",
        "certification_date": "2024-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "FL",
            "license": "11016043",
            "primary": false
        },
        {
            "code": "363LC0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Critical Care Medicine",
            "state": "FL",
            "license": "11016043",
            "primary": false
        },
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "FL",
            "license": "11016043",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Doral, FL

Sources for this page

Verify at the official NPI Registry.