NPIMap

Individual provider Active NPI

Theresa Ann Bolyard, PA-C

  • Physician Assistant
  • Massillon, OH
National Provider Identifier
1770067266
Registry record updated Jul 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
50.005712RX Issued in OH
Practice address
7337 Caritas Cir NW
Massillon, OH 44646-9126
Phone
(330) 830-6110
NPI assigned
Sep 20, 2018
Last updated
Jul 23, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 50.005712RX OH Primary

Addresses

Primary practice location

7337 Caritas Cir NW
Massillon, OH 44646-9126

Mailing address

7337 Caritas Cir NW
Massillon, OH 44646-9126
Phone (330) 830-6110

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL Cantonmercy.org

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
I20190307002723 OH Practitioner - Physician Assistant 5698014702 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Partners Physician GroupGroup PAC ID 4183529340, 409 clinicians

Practice addresses (Care Compare)

1946 Town Park Blvd
Uniontown, OH 44685-8372

224 W Exchange St
Suite 160
Akron, OH 44302-1705
Phone (330) 344-6505

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
50.005712RXOHMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Cleveland Clinic Mercy Hospital CurrentSince Dec 7, 2018 Accepting new patients
Partners Physician Group CurrentSince Nov 15, 2021 Accepting new patients
Cleveland Clinic Mercy Hospital CurrentSince Dec 7, 2018 Accepting new patients
Partners Physician Group CurrentSince Nov 15, 2021 Accepting new patients
Partners Physician Group Past Accepting new patients

Locations

224 W Exchange St
Ste 160
Akron, OH 44302
Phone (330) 344-6505

224 W Exchange St
Ste 225
Akron, OH 44302
Phone (330) 344-7400

1320 Timken Mercy Dr NW
Canton, OH 44708
Phone (330) 489-1000

1330 Mercy Dr NW
Ste 200
Canton, OH 44708
Phone (330) 489-1000

7337 Caritas Cir NW
Massillon, OH 44646
Phone (330) 478-0001

Organizations & group practices 5

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": "1537401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626998400000",
    "number": "1770067266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7337 CARITAS CIR NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469126",
            "telephone_number": "330-830-6110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7337 CARITAS CIR NW",
            "city": "MASSILLON",
            "state": "OH",
            "postal_code": "446469126",
            "telephone_number": "330-830-6110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLYARD",
        "first_name": "THERESA",
        "middle_name": "ANN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-09-20",
        "last_updated": "2021-07-23",
        "certification_date": "2021-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "OH",
            "license": "50.005712RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Cantonmercy.org",
            "affiliation": "N",
            "address_1": "1320 Mercy Dr NW",
            "city": "Canton",
            "state": "OH",
            "country_code": "US",
            "postal_code": "447082641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Massillon, OH

Sources for this page

Verify at the official NPI Registry.