Active NPI
Zachary Bolte
- Student in an Organized Health Care Education/Training Program
- Livonia, MI
National Provider Identifier
1679213946
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Student in an Organized Health Care Education/Training Program
- Practice address
- St Mary Mercy Hospital
36475 Five Mile Road
Livonia, MI 48154 - Phone
- (734) 655-4800
- Fax
- (734) 655-2911
- NPI assigned
- Apr 1, 2022
- Last updated
- Apr 1, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | Primary |
Addresses
Primary practice location
St Mary Mercy Hospital
36475 Five Mile Road
Livonia, MI 48154
Mailing address
St. Mary Mercy Hospital
36475 Five Mile Road
Livonia, MI 48154
Phone (734) 655-4800
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in MI
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220713001688 | MI | Order and Referring Only - Emergency Medicine | 4789065459 |
Care Compare profile
Medicare Care Compare- Specialty
- Emergency Medicine
- Education
- Oregon Health Sciences University School of Medicine, 2022
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
815 NW 9TH St
Suite 215
Corvallis, OR 97330-6173
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648771200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648771200000",
"number": "1679213946",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "ST. MARY MERCY HOSPITAL",
"address_2": "36475 FIVE MILE ROAD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "48154",
"telephone_number": "734-655-4800",
"fax_number": "734-655-2911"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "ST MARY MERCY HOSPITAL",
"address_2": "36475 FIVE MILE ROAD",
"city": "LIVONIA",
"state": "MI",
"postal_code": "48154",
"telephone_number": "734-655-4800",
"fax_number": "734-655-2911"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLTE",
"first_name": "ZACHARY",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-01",
"last_updated": "2022-04-01",
"certification_date": "2022-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "390200000X",
"taxonomy_group": "",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Livonia, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2022; 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.