Alonso Bolivar, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA9018 Issued in MA

Practice address

983 Boston-Providence Turnpike
Dedham, MA 02026

Phone

(781) 819-6400

NPI assigned

Sep 27, 2021

Last updated

Nov 14, 2023By 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

Medicare fee-for-service enrollment

Enrolled in MA, IL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Immediate Care North Chicago LLCGroup PAC ID 8729064159, 256 clinicians

Convenientmd - FFS UC LLCGroup PAC ID 5193186492, 397 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Worcester, MA
  • NPI 1790528628
  Medicare reassignment Care Compare group
• Physicians Immediate Care North Chicago LLC

  • Urgent Care Clinic/Center
  • Chicago, IL
  • NPI 1205814118
  Medicare reassignment Care Compare group
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Saugus, MA
  • NPI 1255022638
  NPD
• Convenientmd - FFS UC LLC

  • Urgent Care Clinic/Center
  • Sturbridge, MA
  • NPI 1386526192
  NPD
• Convenientmd LLC

  • Urgent Care Clinic/Center
  • Newburyport, MA
  • NPI 1316428824
  NPD (past)
• Convenientmd LLC

  • Urgent Care Clinic/Center
  • Dedham, MA
  • NPI 1649879651
  NPD (past)

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

{
    "created_epoch": "1632700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1699920000000",
    "number": "1649941709",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "360 US HIGHWAY 1 BYP UNIT 102",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038017105",
            "telephone_number": "603-410-6700",
            "fax_number": "603-319-8308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "983 BOSTON-PROVIDENCE TURNPIKE",
            "city": "DEDHAM",
            "state": "MA",
            "postal_code": "02026",
            "telephone_number": "781-819-6400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLIVAR",
        "first_name": "ALONSO",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-09-27",
        "last_updated": "2023-11-14",
        "certification_date": "2023-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MA",
            "license": "PA9018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Thrishline Blaise, RN
• David G Blom, MD
• BMSH II LCB Dedham Ma LLC (Traditions of Dedham)
• Rose Thomas Bobby
• Emily Mary Bojorquez, D.P.T
• Samantha Maria Bolivar, PHARM.D., RPH.
• Michelle Bolser, MA, PCC, NBC-HWC
• Rebekah Ann Boral, DMD
• Pietro Bortoletto
• Boston Eye Blink LLC

• Physician Assistant in Dedham, MA
• Providers in Dedham, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2023; 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.