Individual provider Active NPI

Mark James Bolton, M.D.

  • General Practice Physician
  • Columbus, OH
National Provider Identifier
1790785152
Registry record updated Apr 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
69133 Issued in OH
Practice address
420 N James Rd
Columbus, OH 43219-1834
Phone
(614) 257-5000
NPI assigned
Jul 28, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2016

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 69133 OH Primary
Emergency Medicine Physician 207P00000X 69133 OH
Family Medicine Physician 207Q00000X 69133 OH

Addresses

Primary practice location

420 N James Rd
Columbus, OH 43219-1834

Mailing address

8703 Belworth SQ
New Albany, OH 43054-9074
Phone (614) 313-6112

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH, CA, TX, KY, ID, AZ, NM7 enrollments
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 7

Enrollment IDStateProvider typePAC IDDetails
I20031121000178 OH Practitioner - Emergency MedicinePractitioner - Family Practice 0941104913 Reassigns benefits to 1 organization
I20050729000267 CA Practitioner - Emergency Medicine 0941104913 Reassigns benefits to 1 organization
I20060705000278 TX Practitioner - Emergency MedicinePractitioner - Family Practice 0941104913 Reassigns benefits to 2 organizations
I20140416000449 KY Practitioner - Emergency MedicinePractitioner - General Practice 0941104913 Reassigns benefits to 2 organizations
I20171026001918 ID Practitioner - Emergency Medicine 0941104913 Reassigns benefits to 4 organizations
I20230801002176 AZ Practitioner - Family Practice 0941104913 Reassigns benefits to 3 organizations
I20230905002421 NM Practitioner - Family Practice 0941104913 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Loma Linda University School of Medicine, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Summit Emergency Medicine LLCGroup PAC ID 9032546783, 10 clinicians
McAdams Emergency Medicine Associates, PAGroup PAC ID 2567895386, 42 clinicians
Winslow Memorial Hospital IncGroup PAC ID 8628988409, 44 clinicians
Webb Emergency Medicine Associates PAGroup PAC ID 1355305244, 43 clinicians
Lost Rivers Medical CenterGroup PAC ID 7810807427, shared by 4 NPIs, 16 clinicians

Practice addresses (Care Compare)

104 Legion Dr
Las Vegas, NM 87701-4804
Phone (505) 426-3500

1300 E Saunders St
Laredo, TX 78041-5832
Phone (956) 815-4470

1501 N Williamson Ave
Winslow, AZ 86047-2735
Phone (928) 289-4691

2801 Cuatro Vientos Rd
Laredo, TX 78046-2318
Phone (956) 229-6100

551 Highland Dr
Arco, ID 83213-5003
Phone (208) 252-7654

Hospital & facility affiliations

  • Mimbres Valley Medical Center Hospital, Deming, NM, CCN 321309
  • Lost Rivers Medical Center Hospital, Arco, ID, CCN 131324
  • Doctors Hospital of Laredo Hospital, Laredo, TX, CCN 450643
  • Alta Vista Regional Hospital Hospital, Las Vegas, NM, CCN 321312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
69133OHMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Summit Emergency Medicine LLC Emergency Medicine CurrentSince Jan 15, 2026 Accepting new patients
Caribou Medical Center, Inc CurrentSince Jan 17, 2024 Accepting new patients
Taos Health Systems Inc Holy Cross Hospital Emergency Medicine CurrentSince Apr 20, 2023 Accepting new patients
Can Emergency Physicians Medical Group Inc Emergency Medicine CurrentSince Mar 1, 2023 Accepting new patients
Lost Rivers Medical Center Family Medicine CurrentSince Dec 10, 2019 Accepting new patients
Caribou Medical Center, Inc CurrentSince Jan 17, 2024 Accepting new patients
Lost Rivers Medical Center CurrentSince Dec 10, 2019 Accepting new patients
Can Emergency Physicians Medical Group, Inc. Emergency Medicine Current Accepting new patients
Floyd Emergency Group, LLC Emergency Medicine CurrentSince Sep 11, 2016 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital Inc CurrentSince Jan 13, 2024 Accepting new patients
Southwest Emergency Medical Associates of NM PC Emergency Medicine CurrentSince Aug 14, 2025 Accepting new patients
Navajo Health Foundation-Sage Memorial Hospital, Inc. CurrentSince Jan 13, 2024 Accepting new patients
Coast to Coast Wisconsin LLC Emergency Medicine Current Accepting new patients
Winslow Memorial Hospital Inc CurrentSince Jun 1, 2025 Accepting new patients
Fayette County Memorial Hospital Family Medicine Past Accepting new patients
Immediate Health Associates Emergency Medicine Past Accepting new patients
Mid-Ohio Emergency Services, LLC Emergency Medicine Past Accepting new patients
Last Frontier Healthcare District PastSince Nov 21, 2017 Accepting new patients
Lost Rivers Medical Center Family Medicine Past Accepting new patients
Adena Fayette Medical Center Past Accepting new patients
Ross Emergency Group PC, Inc Emergency Medicine Past Accepting new patients
Pine Ridge Indian Health Service Hospital Past Accepting new patients
Marion Physician Billing LLC Emergency Medicine Past Accepting new patients
Muskingum Emergency Physicia Emergency Medicine Past Accepting new patients
Pike County Emergency Physicians Inc Emergency Medicine Past Accepting new patients
Marion General Hospital Foundation, Inc. Emergency Medicine Past Accepting new patients
Circleville Emergency Physicians Inc. Emergency Medicine Past Accepting new patients
Chase Dennis Emergency Medical Group Inc Emergency Medicine Past Accepting new patients

Locations

1501 N Williamson Ave
Winslow, AZ 86047
Phone (928) 289-4691

221 W Second St
Winslow, AZ 86047
Phone (928) 289-4371

1225 Wilshire Blvd
Los Angeles, CA 90017
Phone (213) 482-2741

14662 Newport Ave
Tustin, CA 92780
Phone (714) 619-7700

300 S 3rd W
Soda Springs, ID 83276
Phone (208) 547-0700

5000 Ky Route 321
Prestonsburg, KY 41653
Phone (606) 886-7645

2450 S Telshor Blvd
Las Cruces, NM 88011
Phone (505) 522-8641

104 Legion Dr
Las Vegas, NM 87701
Phone (505) 426-3500

1397 Weimer Rd
Taos, NM 87571
Phone (575) 751-5746

5195 Hampsted Village Center Way
New Albany, OH 43054
Phone (614) 420-6554

Interoperability endpoints

  • Direct secure messaging: mark.bolton.2@11894.direct.athenahealth.com
  • Direct secure messaging: mark.bolton@avera.sdhealthlink.net
  • Direct secure messaging: mbolto01@yourcarecommunity.org

Organizations & group practices 32

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 32

Hospital & facility affiliations 4

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": "1122508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1460419200000",
    "number": "1790785152",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8703 BELWORTH SQ",
            "city": "NEW ALBANY",
            "state": "OH",
            "postal_code": "430549074",
            "telephone_number": "614-313-6112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 N JAMES RD",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432191834",
            "telephone_number": "614-257-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "MARK",
        "middle_name": "JAMES",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-28",
        "last_updated": "2016-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "OH",
            "license": "69133",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "OH",
            "license": "69133",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OH",
            "license": "69133",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

Verify at the official NPI Registry.