Individual provider Active NPI

Sarah Boltik, DO

  • Pediatrics Physician
  • Lexington, KY
National Provider Identifier
1780111088
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
05006 Issued in KY
Practice address
840 Quarter Horse CT
Lexington, KY 40503-5459
Phone
(702) 817-5002
NPI assigned
May 17, 2017
Last updated
Jul 7, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 05006 KY Primary

Addresses

Primary practice location

840 Quarter Horse CT
Lexington, KY 40503-5459

Mailing address

840 Quarter Horse CT
Lexington, KY 40503-5459
Phone (702) 817-5002

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211228002194 KY Practitioner - Pediatric Medicine 3577954684 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
05006KYMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Spring View Physician Practices, LLC CurrentSince Jan 1, 2022 Accepting new patients
Spring View Physician Practices, LLC Current Accepting new patients
Spring View Physician Practices LLC CurrentSince Jan 1, 2022 Accepting new patients
Spring View Physician Practices, LLC Past Accepting new patients
Spring View Hospital LLC Past Accepting new patients

Locations

330 N Loretto Rd
Lebanon, KY 40033
Phone (270) 699-2229

420 N Loretto Rd
Ste 600
Lebanon, KY 40033
Phone (270) 692-5139

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: sarah.boltik.1@30070.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1494979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625616000000",
    "number": "1780111088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "840 QUARTER HORSE CT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405035459",
            "telephone_number": "702-817-5002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "840 QUARTER HORSE CT",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405035459",
            "telephone_number": "702-817-5002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTIK",
        "first_name": "SARAH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-17",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "KY",
            "license": "05006",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.