Active NPI
Matthew Bolshin
- Foot & Ankle Surgery Podiatrist
- Beverly Hills, CA
National Provider Identifier
1841932902
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Foot & Ankle Surgery Podiatrist
- License
- E5863
- Practice address
- 9100 Wilshire Blvd Ste 280E
Beverly Hills, CA 90212-3562 - Phone
- (310) 652-3668
- NPI assigned
- Apr 10, 2022
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Foot & Ankle Surgery Podiatrist | 213ES0103X | E5863 | CA | Primary |
Addresses
Primary practice location
9100 Wilshire Blvd Ste 280E
Beverly Hills, CA 90212-3562
Mailing address
209 E 7TH Ave
Apt 907
Vancouver, BRITISH COLUMBIA V5T 0H3
CA
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| E5863 | CA | MD | Foot & Ankle Surgery Podiatrist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1649548800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1649548800000",
"number": "1841932902",
"addresses": [
{
"country_code": "CA",
"country_name": "Canada",
"address_purpose": "MAILING",
"address_type": "FGN",
"address_1": "209 E 7TH AVE",
"address_2": "APT 907",
"city": "VANCOUVER",
"state": "BRITISH COLUMBIA",
"postal_code": "V5T 0H3"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9100 WILSHIRE BLVD STE 280E",
"city": "BEVERLY HILLS",
"state": "CA",
"postal_code": "902123562",
"telephone_number": "310-652-3668"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOLSHIN",
"first_name": "MATTHEW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2022-04-10",
"last_updated": "2022-04-10",
"certification_date": "2022-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "213ES0103X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Podiatrist, Foot & Ankle Surgery",
"state": "CA",
"license": "E5863",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Beverly Hills, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.