Individual provider Active NPI

Nelson Forrest Boland, MD

  • Family Medicine Physician
  • Santa Monica, CA
National Provider Identifier
1649739764
Registry record updated Feb 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
A179762 Issued in CA
Practice address
1225 15TH St Ste 2100
Santa Monica, CA 90404-1101
Phone
(310) 319-1234
NPI assigned
Mar 18, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 10, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X A179762 CA
Family Medicine Physician 207Q00000X A179762 CA Primary

Addresses

Primary practice location

1225 15TH St Ste 2100
Santa Monica, CA 90404-1101

Mailing address

5767 W Century Blvd Ste 400
Los Angeles, CA 90045-5631

Other practice location 1

1920 Colorado Ave
Santa Monica, CA 90404-3414
Phone (410) 319-4711

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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

Enrollment IDStateProvider typePAC IDDetails
I20221004001723 CA Practitioner - Family Practice 7416333117 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Baylor College of Medicine, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Regents of the University of CaliforniaGroup PAC ID 1355248584, 1,426 clinicians

Practice addresses (Care Compare)

2020 Santa Monica Blvd
Suite 210
Santa Monica, CA 90404-2139
Phone (310) 458-2381

23815 Stuart Ranch Rd
Malibu, CA 90265-4861

Hospital & facility affiliations

  • Veroma Home Health, Inc Home health agency, Encino, CA, CCN 053103
  • Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262
  • Santa Monica - UCLA Med Ctr & Orthopaedic Hospital Hospital, Santa Monica, CA, CCN 050112

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions39

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
A179762CAMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Regents of the University of California CurrentSince Sep 1, 2023 Accepting new patients
The Regents of the University of California Family Medicine CurrentSince Sep 1, 2023 Accepting new patients
Regents of the University of California Past Accepting new patients
UCLA Medical Group Family Medicine Past Accepting new patients

Locations

24302 Paseo de Valencia
Ste 200
Laguna Hills, CA 92653
Phone (949) 458-8252

File 55737
Los Angeles, CA 90074

5767 W Century Blvd
Ste 400
Los Angeles, CA 90045
Phone (310) 301-5200

757 Westwood Plz
Los Angeles, CA 90095
Phone (310) 267-9448

23815 Stuart Ranch Rd
#300
Malibu, CA 90265
Phone (310) 456-1668

2020 Santa Monica Blvd
Ste 210
Santa Monica, CA 90404
Phone (310) 458-2381

1225 15th St
Ste 2100
Santa Monica, CA 90404
Phone (424) 259-6560

1250 16th St
Santa Monica, CA 90404
Phone (310) 301-8695

1920 Colorado Ave
Santa Monica, CA 90404
Phone (310) 319-4700

100 Moody Ct
Ste 200
Thousand Oaks, CA 91360
Phone (805) 418-3500

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 and National Provider Directory roles.

Hospital & facility affiliations 3

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": "1552867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739145600000",
    "number": "1649739764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5767 W CENTURY BLVD STE 400",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900455631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 15TH ST STE 2100",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904041101",
            "telephone_number": "310-319-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1920 Colorado Ave",
            "address_purpose": "LOCATION",
            "city": "Santa Monica",
            "state": "CA",
            "postal_code": "904043414",
            "country_code": "US",
            "telephone_number": "410-319-4711",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLAND",
        "first_name": "NELSON",
        "middle_name": "FORREST",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-18",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "CA",
            "license": "A179762",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "CA",
            "license": "A179762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santa Monica, CA

Sources for this page

Verify at the official NPI Registry.