Maria Bolanos, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

DO20473 Issued in OR

Practice address

2073 Olympic Street
Springfield, OR 97477-3413

Phone

(541) 682-3550

Fax

(541) 682-3551

NPI assigned

Jan 18, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OR

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

Family Practice

Education

At Still University of Health Sciences, College of Osteo Med, Kirksville, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lane County OregonGroup PAC ID 7416853833, 31 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: maria.bolanos.p1@direct.lanecounty.nextgenshare.com
• Direct secure messaging: mbolanos684199@direct.ochin.org
• Direct secure messaging: mcbolano@yourcarecommunity.org

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.

• Lane County Oregon

  • Federally Qualified Health Center (FQHC)
  • Springfield, OR
  • NPI 1326138314
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1169078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1328572800000",
    "number": "1801949417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2073 OLYMPIC STREET",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974773413",
            "telephone_number": "541-682-3550",
            "fax_number": "541-682-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2073 OLYMPIC STREET",
            "city": "SPRINGFIELD",
            "state": "OR",
            "postal_code": "974773413",
            "telephone_number": "541-682-3550",
            "fax_number": "541-682-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANOS",
        "first_name": "MARIA",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-01-18",
        "last_updated": "2012-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "OR",
            "license": "DO20473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "150494",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kimberly A Bock, M.D.
• Brooke A Bodeen, N.D.
• Dawn M Bodell, DO
• Mark N Bodily, MD
• Callay Quinn Boire-Shedd
• Elizabeth Larkin Bolen, MSMFT
• Stacey O'Shea Bonomo, LPN
• Sarah M Boothe
• Lizbeth Borchardt, CRNA
• Dean Born

• Family Medicine Physician in Springfield, OR
• Providers in Springfield, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; 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.