NPIMap

Individual provider Active NPI

Nancy A Bolanis, MD

  • Diagnostic Radiology Physician
  • Newton, MA
National Provider Identifier
1811975600
Registry record updated Sep 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
212726 Issued in MA
Practice address
2014 Washington St
Newton Wellesley Radiology Associates
Newton, MA 02462
Phone
(617) 243-6600
NPI assigned
Jan 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2011

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Body Imaging Physician 2085B0100X 212726 MA
Diagnostic Radiology Physician 2085R0202X 212726 MA Primary

Addresses

Primary practice location

2014 Washington St
Newton Wellesley Radiology Associates
Newton, MA 02462

Mailing address

PO Box 417400
Newton Wellesley Radiology Associates
Boston, MA 02241-0001
Phone (800) 360-4391

Other identifiers 3

IdentifierTypeStateIssuer
0199648MedicaidMA
J25265OtherMABS
7707370OtherAETNA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
212726MAMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Brigham and Womens Physicians Organization Inc Body Imaging Past Accepting new patients
Coolidge Corner Imaging, LLC Diagnostic Radiology Past Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1136246400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317081600000",
    "number": "1811975600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417400",
            "address_2": "NEWTON WELLESLEY RADIOLOGY ASSOCIATES",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022410001",
            "telephone_number": "800-360-4391",
            "fax_number": "770-776-5702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2014 WASHINGTON ST",
            "address_2": "NEWTON WELLESLEY RADIOLOGY ASSOCIATES",
            "city": "NEWTON",
            "state": "MA",
            "postal_code": "02462",
            "telephone_number": "617-243-6600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLANIS",
        "first_name": "NANCY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-01-03",
        "last_updated": "2011-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": "MA",
            "license": "212726",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MA",
            "license": "212726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0199648",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "J25265",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7707370",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Newton, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.