Jennifer E Boll, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

36586 Issued in AZ

Practice address

2034 W Southern Ave
Suite Y
Tempe, AZ 85282

Phone

(480) 833-5200

Fax

(480) 833-2967

NPI assigned

Jan 20, 2006

Last updated

Mar 23, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Specialty

Plastic and Reconstructive Surgery

Education

University of Alabama School of Medicine, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AFFJBA/Endpoint/AFFJBA

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.

• Jennifer E Boll MD Inc

  • Plastic Surgery Physician
  • Tempe, AZ
  • NPI 1598950727
  Medicare reassignment NPD Authorized official
• Western Cardiothoracic Surgeons, PLC

  • Surgery Physician
  • Phoenix, AZ
  • NPI 1295877090
  NPD (past)

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

{
    "created_epoch": "1137715200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521763200000",
    "number": "1780664243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2034 W SOUTHERN AVE",
            "address_2": "SUITE Y",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "480-833-5200",
            "fax_number": "480-833-2967"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2034 W SOUTHERN AVE",
            "address_2": "SUITE Y",
            "city": "TEMPE",
            "state": "AZ",
            "postal_code": "85282",
            "telephone_number": "480-833-5200",
            "fax_number": "480-833-2967"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1520 S Dobson Rd",
            "address_2": "Suite 314",
            "address_purpose": "LOCATION",
            "city": "Mesa",
            "state": "AZ",
            "postal_code": "852024725",
            "country_code": "US",
            "telephone_number": "480-833-5200",
            "fax_number": "480-833-2967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLL",
        "first_name": "JENNIFER",
        "middle_name": "E",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-01-20",
        "last_updated": "2018-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0122X",
            "taxonomy_group": "",
            "desc": "Surgery, Plastic and Reconstructive Surgery",
            "state": "MN",
            "license": "47854",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "AZ",
            "license": "36586",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "020910400",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Emily N Bohn, BS, RBT
• Linda Bohnet, LPC
• Katalin H Boleratzky, MD
• Donald J Boles Jr., MD
• Jenny Lou Boles, NURSE PRACTITIONER
• Molly Anne Bond, DC
• Brittany Bonfield, NP
• Elizabeth Boomer
• Melissa Ann Bootz
• Stephen Lawrence Borodkin, M.D.

• Plastic Surgery Physician in Tempe, AZ
• Providers in Tempe, AZ by specialty
• Plastic Surgery Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2018; 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.

Verify at the official NPI Registry.