Peter M Bolo, MD

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

MA53194 Issued in NJ

Practice address

99 Beauvoir Avenue
Summit, NJ 07902-3533

Phone

(908) 522-2226

Fax

(908) 522-5269

NPI assigned

Jul 28, 2006

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 1

Medicare fee-for-service enrollment

Enrolled in NJ

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

Psychiatry

Education

Columbia University College of Physicians and Surgeons, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Practice Associates Medical GroupGroup PAC ID 5890703177, 1,412 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Overlook Medical Center Hospital, Summit, NJ, CCN 310051
• Chilton Medical Center Hospital, Pompton Plains, NJ, CCN 310017

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Practice Associates Medical Group

  dba Atlantic Medical Group

  • Internal Medicine Physician
  • Morristown, NJ
  • NPI 1427016385
  Medicare reassignment Care Compare group NPD

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

• Ahs Hospital Corp.

  dba Overlook Hospital

  • General Acute Care Hospital
  • Summit, NJ
  • NPI 1740254143
  Care Compare affiliation
• Ahs Hospital Corp.

  dba Chilton Medical Center

  • General Acute Care Hospital
  • Pompton Plains, NJ
  • NPI 1811994809
  Care Compare affiliation

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1649284639",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVENUE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079023533",
            "telephone_number": "908-522-2226",
            "fax_number": "908-522-5269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99 BEAUVOIR AVENUE",
            "city": "SUMMIT",
            "state": "NJ",
            "postal_code": "079023533",
            "telephone_number": "908-522-2226",
            "fax_number": "908-522-5269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLO",
        "first_name": "PETER",
        "middle_name": "M",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NJ",
            "license": "MA53194",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6358802",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Katherine Blizzard, LPN
• Reena Bloom, AUD
• Neil Sagar Bobba, MBBS
• Elisa Susan Bobrow, PH.D.
• John Bogojovski, FNP-BC
• Mary C Bolwell
• Adwoah Pinamang Bonsu, ANP-BC
• John Matthew Boozan, M.D.
• Kathleen M Boreale, NP
• Mina Botros, M.D.

• Psychiatry Physician in Summit, NJ
• Providers in Summit, NJ by specialty
• Psychiatry Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.