Individual provider Active NPI

Jason A. Bolyard, CRNA

  • Certified Registered Nurse Anesthetist
  • Kansas City, MO
National Provider Identifier
1790954501
Registry record updated Aug 31, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
2005029853 Issued in MO
Practice address
4401 Wornall Rd
Anesthesia Dept
Kansas City, MO 64111-3220
Phone
(816) 389-6030
Fax
(816) 389-6034
NPI assigned
Feb 26, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 2005029853 MO Primary

Addresses

Primary practice location

4401 Wornall Rd
Anesthesia Dept
Kansas City, MO 64111-3220

Mailing address

PO Box 504407
Saint Louis, MO 63150-4407
Phone (816) 502-7000

Other identifiers 2

IdentifierTypeStateIssuer
SRNAOtherSTUDENT
2005029853OtherMOLICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, KS2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20080804000571 MO Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365516606 Reassigns benefits to 1 organization
I20150922000360 KS Practitioner - Certified Registered Nurse Anesthetist (Crna) 2365516606 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
University of Kansas School of Med (KC/Wich/Sal), 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Saint Lukes Physician Group IncGroup PAC ID 3577476894, 1,233 clinicians

Practice addresses (Care Compare)

1001 6TH Ave
Leavenworth, KS 66048-3248

12300 Metcalf Ave
Overland Park, KS 66213-1324
Phone (913) 317-7000

12330 Metcalf Ave
Overland Park, KS 66213-1324

4401 Wornall Rd
Kansas City, MO 64111-3220
Phone (816) 932-3100

711 Marshall St
Leavenworth, KS 66048-3235
Phone (913) 684-1100

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.56 of 100Reported as group
Quality
76.07
Promoting interoperability
100
Improvement activities
40
Cost
65.79

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
2005029853MOMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Saint Luke'S Physician Group Inc Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2018 Accepting new patients
Westport Anesthesia Services of Missouri, PC Past Accepting new patients

Locations

711 Marshall St
Leavenworth, KS 66048
Phone (913) 684-1100

5405 W 151st St
Leawood, KS 66224
Phone (913) 323-8830

12330 Metcalf Ave
Ste 500A
Overland Park, KS 66213
Phone (913) 323-9000

12541 Foster St
Ste 100
Overland Park, KS 66213
Phone (913) 317-3100

12300 Metcalf Ave
Shawnee Mission, KS 66213
Phone (913) 317-7000

901 E 104th St
Kansas City, MO 64131
Phone (816) 502-7117

4401 Wornall Rd
Kansas City, MO 64111
Phone (816) 932-2107

901 E 104th St
#400N
Kansas City, MO 64131
Phone (816) 502-8756

601 S US Highway 169
Smithville, MO 64089
Phone (816) 532-3999

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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": "1203984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440979200000",
    "number": "1790954501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 504407",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631504407",
            "telephone_number": "816-502-7000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 WORNALL RD",
            "address_2": "ANESTHESIA DEPT",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641113220",
            "telephone_number": "816-389-6030",
            "fax_number": "816-389-6034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLYARD",
        "first_name": "JASON",
        "middle_name": "A.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-26",
        "last_updated": "2015-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MO",
            "license": "2005029853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STUDENT",
            "identifier": "SRNA",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "2005029853",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kansas City, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.