NPIMap

Individual provider Active NPI

Stephen Laurence Bolt, M.D.

  • Anesthesiology Physician
  • Tacoma, WA
National Provider Identifier
1710967237
Registry record updated Dec 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
MD60833931 Issued in WA
Practice address
1717 S J St
Tacoma, WA 98405-4933
Phone
(844) 364-2778
Fax
(253) 383-0161
NPI assigned
Jan 19, 2006
Last updated
Dec 1, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 0101045085 VA
Pain Medicine (Anesthesiology) Physician 207LP2900X 0101045085 VA
Anesthesiology Physician 207L00000X MD60833931 WA Primary

Addresses

Primary practice location

1717 S J St
Tacoma, WA 98405-4933

Mailing address

1717 S J St
Tacoma, WA 98405-4933
Phone (844) 364-2778

Other practice location 1

11315 Bridgeport Way SW
Lakewood, WA 98499-3004
Phone (253) 985-6403

Other practice location 2

9040-A Fitzsimmons Drive
Tacoma, WA 98431-0001
Phone (253) 968-1975

Other identifiers 1

IdentifierTypeStateIssuer
2104430MedicaidWA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sbolt274301@fhsce.catholichealth.net
Direct Messaging Address sbolt274301@fhsce.catholichealth.net Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180606001671 WA Practitioner - Anesthesiology 4789949173 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Uniformed Services Uhs Fe Hebert School of Med, 1988
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1708 Yakima Ave
201 Ms 03 21
Tacoma, WA 98405-5300

1717 S J St
Tacoma, WA 98405-4933

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD60833931WAMDAnesthesiology Physician
0101045085VAMDPain Medicine (Anesthesiology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Franciscan Medical Group Current Accepting new patients
Franciscan Medical Group CurrentSince Apr 30, 2018 Accepting new patients
Franciscan Medical Group Anesthesiology CurrentSince Apr 30, 2018 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

1717 S J St
#136
Tacoma, WA 98405
Phone (253) 426-6363

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

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

Hospital & facility affiliations 6

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": "1137628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606780800000",
    "number": "1710967237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "844-364-2778",
            "fax_number": "253-383-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1717 S J ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054933",
            "telephone_number": "844-364-2778",
            "fax_number": "253-383-0161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11315 Bridgeport Way SW",
            "address_purpose": "LOCATION",
            "city": "Lakewood",
            "state": "WA",
            "postal_code": "984993004",
            "country_code": "US",
            "telephone_number": "253-985-6403",
            "fax_number": "253-985-2948",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9040-A Fitzsimmons Drive",
            "address_purpose": "LOCATION",
            "city": "Tacoma",
            "state": "WA",
            "postal_code": "984310001",
            "country_code": "US",
            "telephone_number": "253-968-1975",
            "fax_number": "253-968-3738",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLT",
        "first_name": "STEPHEN",
        "middle_name": "LAURENCE",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-19",
        "last_updated": "2020-12-01",
        "certification_date": "2020-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "VA",
            "license": "0101045085",
            "primary": false
        },
        {
            "code": "207LP2900X",
            "taxonomy_group": "",
            "desc": "Anesthesiology, Pain Medicine",
            "state": "VA",
            "license": "0101045085",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "WA",
            "license": "MD60833931",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2104430",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbolt274301@fhsce.catholichealth.net",
            "affiliation": "N",
            "address_1": "11315 Bridgeport Way SW",
            "city": "Lakewood",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984993004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sbolt274301@fhsce.catholichealth.net",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1717 S J St",
            "city": "Tacoma",
            "state": "WA",
            "country_code": "US",
            "postal_code": "984054933",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

Verify at the official NPI Registry.