NPIMap

Organization Active NPI

Bhupinder Singh Bolla MD PLLC

Doing business as Pain Solutions of Northern New York

  • Durable Medical Equipment & Medical Supplies
  • Watertown, NY
National Provider Identifier
1669002697
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
BHUPINDER SINGH BOLLA MD PLLC
Doing business as
Pain Solutions of Northern New York
Practice address
26561 State Route 3 Ste a
Watertown, NY 13601-1749
Phone
(315) 782-7246
Fax
(315) 782-7247
NPI assigned
Jan 17, 2020
Last updated
Jan 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Authorized official

Name
Bhupinder S BollaNPI 1386680874
Title
Owner/Provider
Phone
(315) 782-7246

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Interventional Pain Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208VP0014X
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

26561 State Route 3 Ste a
Watertown, NY 13601-1749

Mailing address

26561 State Route 3 Ste a
Watertown, NY 13601-1749
Phone (315) 782-7246

Other names 1

  • Pain Solutions of Northern New York Doing business as

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
33D2051650Bhupinder Singh Bolla, MD, PLLC26561 State Route 3, Watertown, NY 13601Certificate of waiverDec 23, 2026

National Provider Directory

National Provider Directory

Locations

26561 State Route 3
Ste A
Watertown, NY 13601
Phone (315) 782-7246

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1579219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1669002697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26561 STATE ROUTE 3 STE A",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011749",
            "telephone_number": "315-782-7246",
            "fax_number": "315-782-7247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "26561 STATE ROUTE 3 STE A",
            "city": "WATERTOWN",
            "state": "NY",
            "postal_code": "136011749",
            "telephone_number": "315-782-7246",
            "fax_number": "315-782-7247"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BHUPINDER SINGH BOLLA MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-17",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "BOLLA",
        "authorized_official_first_name": "BHUPINDER",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "315-782-7246"
    },
    "taxonomies": [
        {
            "code": "208VP0014X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pain Medicine, Interventional Pain Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pain Solutions of Northern New York",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pain Solutions of Northern New York",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Watertown, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.