James M. Bolanos, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

PA10002147 Issued in WA

Practice address

520 N Chelan Ave
Wenatchee, WA 98801-6697

Phone

(509) 662-2211

Fax

(509) 662-8756

NPI assigned

Oct 17, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• Wenatchee Valley Hospital

  • Multi-Specialty Clinic/Center
  • Wenatchee, WA
  • NPI 1669719688
  Medicare reassignment NPD

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436832000000",
    "number": "1811077332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012028",
            "telephone_number": "509-663-8711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N CHELAN AVE",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988016697",
            "telephone_number": "509-662-2211",
            "fax_number": "509-662-8756"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANOS",
        "first_name": "JAMES",
        "middle_name": "M.",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2015-07-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "WA",
            "license": "PA10002147",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WVH LNI",
            "identifier": "322540",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811077332",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE WVH",
            "identifier": "P01428922",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fred P Bockenstedt, MD
• Mabel Amelia Bodell, MD
• Krista Miller Bodrey, M.D.
• Daniel Boers, DDS, MPH
• Alexandra L Bohn, LMP
• Rachel Ryan Bollens, REGISTERED NURSE
• Jonathan Andrew Bolles, MD
• Justina M Bolz, MD
• Richy Bonillas
• Shandi Carroll Bookwalter

• Surgical Physician Assistant in Wenatchee, WA
• Providers in Wenatchee, WA by specialty
• Surgical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2015; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.