Sidney Jefferson Bolch III, M.D.

Primary specialty

Cardiovascular Disease PhysicianTaxonomy code 207RC0000X

License

016876 Issued in GA

Practice address

1326 Eisenhower Dr
BLDG. 2
Savannah, GA 31406-3928

Phone

(912) 527-5300

Fax

(912) 527-5149

NPI assigned

Jul 13, 2005

Last updated

Jun 25, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in GA

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

Cardiovascular Disease (Cardiology)

Education

Medical College of Georgia School of Medicine, 1974

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

SJ SC Cardiology LLCGroup PAC ID 1052607371, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Candler Hospital Hospital, Savannah, GA, CCN 110024
• St Joseph's Hospital - Savannah Hospital, Savannah, GA, CCN 110043
• Appling Healthcare Hospital, Baxley, GA, CCN 110071

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sidneybolch@scmgllc.allscriptsdirect.net
• Direct secure messaging: sidneybolch@sjscllc.allscriptsdirect.net

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.

• SJ SC Cardiology LLC

  • Cardiovascular Disease Physician
  • Savannah, GA
  • NPI 1245694496
  Medicare reassignment Care Compare group NPD

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

• Candler Hospital Incorporated

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1275527889
  Care Compare affiliation
• Saint Joseph's Hospital, Inc.

  • General Acute Care Hospital
  • Savannah, GA
  • NPI 1063406684
  Care Compare affiliation
• The Baxley and Appling County Hospital Authority

  dba appling healthcare system

  • General Acute Care Hospital
  • Baxley, GA
  • NPI 1861615304
  Care Compare affiliation

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

{
    "created_epoch": "1121212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1214352000000",
    "number": "1639177595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1326 EISENHOWER DR",
            "address_2": "BLDG. 2",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063928",
            "telephone_number": "912-527-5300",
            "fax_number": "912-527-5149"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1326 EISENHOWER DR",
            "address_2": "BLDG. 2",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314063928",
            "telephone_number": "912-527-5300",
            "fax_number": "912-527-5149"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLCH",
        "first_name": "SIDNEY",
        "middle_name": "JEFFERSON",
        "name_suffix": "III",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-13",
        "last_updated": "2008-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "GA",
            "license": "016876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "G16876",
            "state": "SC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000176712R",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000176712C",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000932412A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000176712Z",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000932412B",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "060065859",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000176712AA",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "082552",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristyn R. Bohrer, REGISTERED NURSE
• Boland Eye Center PC
• Boland Women's Imaging PC
• Pamela Boland, M.D.
• Ryan Franklin Boland, M.D.
• Boles Global Telepsychiatry
• Shaheedah Boles
• Skylar Bolla, BCBA
• David Matthew Bond, DDS
• Denean Bonds, MSW

• Cardiovascular Disease Physician in Savannah, GA
• Providers in Savannah, GA by specialty
• Cardiovascular Disease Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; 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.