Individual provider Active NPI

David A Bollard, DO

  • Family Medicine Physician
  • Sparta, NJ
National Provider Identifier
1831185768
Registry record updated Oct 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
25MB05026800 Issued in NJ
Practice address
89 Sparta Ave
Suite 100
Sparta, NJ 07871-1777
Phone
(973) 729-2121
Fax
(973) 729-3454
NPI assigned
Sep 26, 2005
Last updated
Oct 20, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 25MB05026800 NJ Primary

Addresses

Primary practice location

89 Sparta Ave
Suite 100
Sparta, NJ 07871-1777

Mailing address

532 Lafayette Rd
Suite 300
Sparta, NJ 07871-4411
Phone (973) 940-0423

Other identifiers 1

IdentifierTypeStateIssuer
1489402MedicaidNJ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20101207001074 NJ Practitioner - Family PracticePractitioner - General Practice 9830088533 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Premier Health Associates LLCGroup PAC ID 0840283008, 45 clinicians

Practice addresses (Care Compare)

123 Newton Sparta Rd
Newton, NJ 07860-2769
Phone (973) 579-6300

715 Route 10 E
Randolph, NJ 07869-2025
Phone (973) 343-7040

89 Sparta Ave
Sparta, NJ 07871-1777
Phone (973) 209-1550

89 Sparta Ave
Suite 100
Sparta, NJ 07871-1790
Phone (973) 729-2121

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
78.05 of 100Reported as apm
Quality
65.09
Promoting interoperability
85
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MB05026800NJMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Premier Health Associates LLC CurrentSince Oct 1, 2012 Accepting new patients
Sparta Medical Associates, P.a. Family Medicine Current Accepting new patients
Premier Health Associates, LLC CurrentSince Oct 1, 2012 Accepting new patients

Locations

123 Newton Sparta Rd
Newton, NJ 07860
Phone (973) 579-1000

21 Lafayette Rd
Ste C
Sparta, NJ 07871
Phone (973) 729-0291

532 Lafayette Rd
Ste 300
Sparta, NJ 07871
Phone (973) 940-0423

89 Sparta Ave
Ste 100
Sparta, NJ 07871
Phone (973) 729-2121

Interoperability endpoints

  • Direct secure messaging: davidbollard@premiernj.allscriptsdirect.net
  • Direct secure messaging: dbollard98612@direct.ahsys.org
  • FHIR API: https://fhir4.healow.com/fhir/r4/EDJHBA

Organizations & group practices 3

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

Hospital & facility affiliations 5

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": "1127692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319068800000",
    "number": "1831185768",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "532 LAFAYETTE RD",
            "address_2": "SUITE 300",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078714411",
            "telephone_number": "973-940-0423",
            "fax_number": "973-940-0399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "89 SPARTA AVE",
            "address_2": "SUITE 100",
            "city": "SPARTA",
            "state": "NJ",
            "postal_code": "078711777",
            "telephone_number": "973-729-2121",
            "fax_number": "973-729-3454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLLARD",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-26",
        "last_updated": "2011-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MB05026800",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1489402",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sparta, NJ

Sources for this page

Verify at the official NPI Registry.