NPIMap

Individual provider Active NPI

John Boltri, MD

  • Family Medicine Physician
  • Akron, OH
National Provider Identifier
1730155128
Registry record updated Aug 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
35.057005 Issued in OH
Practice address
55 Arch St Ste 3a
Akron, OH 44304-1447
Phone
(330) 375-3911
NPI assigned
Feb 24, 2006
Last updated
Aug 8, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 35.057005 OH Primary

Addresses

Primary practice location

55 Arch St Ste 3a
Akron, OH 44304-1447

Mailing address

461 Victoria Park Dr
Tallmadge, OH 44278-1574
Phone (478) 714-9345

Other identifiers 1

IdentifierTypeStateIssuer
000502268FMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20160812001955 OH Practitioner - Family Practice 6608063987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Ohio State University College of Medicine, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summa Physicians LLCGroup PAC ID 2961303532, 692 clinicians

Practice addresses (Care Compare)

525 E Market St
Akron, OH 44304-1619

55 Arch St
Suite 3a
Akron, OH 44304-1447
Phone (330) 375-3584

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Summa Physicians LLC Family Medicine CurrentSince May 18, 2016 Accepting new patients
Summa Physicians LLC Current Accepting new patients
Summa Physicians LLC CurrentSince May 18, 2016 Accepting new patients
Health Services of Central Georgia, Inc Family Medicine PastSince Jun 1, 2004 Accepting new patients
Central Georiga Fertility Institute Past Accepting new patients
Summa Physicians LLC Past Accepting new patients

Locations

1077 Gorge Blvd
Akron, OH 44310
Phone (234) 312-5691

525 E Market St
Akron, OH 44304
Phone (330) 375-6350

55 Arch St
Ste 3A
Akron, OH 44304
Phone (330) 375-3584

Organizations & group practices 6

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 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": "1140739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1730155128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "461 VICTORIA PARK DR",
            "city": "TALLMADGE",
            "state": "OH",
            "postal_code": "442781574",
            "telephone_number": "478-714-9345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 ARCH ST STE 3A",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443041447",
            "telephone_number": "330-375-3911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTRI",
        "first_name": "JOHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-24",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "35.057005",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000502268F",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.