Ran Bolen

Individual provider Active NPI General Acute Care Hospital · Flint, TX

NPI 1891291845 · NPPES record last updated Mar 30, 2018

Key facts

NPI
1891291845
Entity type
Individual (NPI type 1)
Primary specialty
General Acute Care Hospital 282N00000X
License
AP136199 (TX)
Practice address
20894 Virginia Rd
Flint, TX 75762-5418
Phone
(903) 571-2135
NPI assigned
Mar 30, 2018
Sex
Male
Sole proprietor
Yes

Organizations & group practices 1

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.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

Medicare Care Compare profile

Specialty
Nurse Practitioner
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hospital Medicine Associates of TX PA (8 clinicians)

Practice addresses (Care Compare)

2900 S Loop
Suite 256
Palestine, TX 75801-6958
Phone (903) 731-1000

Hospital & facility affiliations

  • Palestine Regional Medical Center Hospital · Palestine, TX · CCN 450747
  • Crockett Medical Center Hospital · Crockett, TX · CCN 451393

Medicare participation

Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20180709000551 TX Practitioner - Nurse Practitioner 8729334636 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP136199TXMDRural Acute Care Hospital

Practice roles

OrganizationSpecialtyStatusNew patients
Hospital Medicine Associates of TX PA Current
since May 15, 2018
Accepting new patients

Locations

2900 S Loop 256
Palestine, TX 75801
Phone (903) 731-1021

16100 South Fwy
Pearland, TX 77584
Phone (713) 413-5000

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Acute Care Hospital 282NR1301X AP136199 TX
General Acute Care Hospital 282N00000X AP136199 TX Yes

Addresses

Primary practice location

20894 Virginia Rd
Flint, TX 75762-5418

Mailing address

900 TX-256 South Loop
Palestine, TX 75801
Phone (903) 731-1000

Other providers in Flint, TX

All providers in Flint, TX · General Acute Care Hospital in Texas

Sources for this page

Verify at the official NPI Registry.