Jacob C Bolyard, DO

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

125076677 Issued in IL

Practice address

Cleveland Clinic 9500 Euclid Avenue/JJ24
Cleveland, OH 44195-3328

Phone

(216) 444-2200

NPI assigned

Mar 31, 2020

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in IL

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

Specialty

Anesthesiology

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jbolyard114423@direct.luhs.org

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.

• Northwestern Medical Faculty Foundation

  • Multi-Specialty Clinic/Center
  • Carol Stream, IL
  • NPI 1346235314
  Medicare reassignment Care Compare group NPD
• Loyola University Medical Center

  • General Acute Care Hospital
  • Maywood, IL
  • NPI 1376521575
  NPD
• Northwestern Medical Faculty Foundation

  • Durable Medical Equipment & Medical Supplies
  • Chicago, IL
  • NPI 1417718479
  NPD

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

• Central Dupage Hospital Association

  • General Acute Care Hospital
  • Winfield, IL
  • NPI 1003864810
  Care Compare affiliation
• Central Dupage Hospital Association

  • Psychiatric Hospital Unit
  • Winfield, IL
  • NPI 1740230895
  Care Compare affiliation

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754438400000",
    "number": "1891323341",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3262 WAVERLY WOODS LN",
            "city": "HOWELL",
            "state": "MI",
            "postal_code": "488439587",
            "telephone_number": "517-375-5263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "CLEVELAND CLINIC 9500 EUCLID AVENUE/JJ24",
            "city": "CLEVELAND",
            "state": "OH",
            "postal_code": "441953328",
            "telephone_number": "216-444-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 N Winfield Rd",
            "address_purpose": "LOCATION",
            "city": "Winfield",
            "state": "IL",
            "postal_code": "601901379",
            "country_code": "US",
            "telephone_number": "630-933-6675",
            "fax_number": "630-933-2614",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLYARD",
        "first_name": "JACOB",
        "middle_name": "C",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2025-08-06",
        "certification_date": "2025-08-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "036161977",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "IL",
            "license": "125076677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chaz Bolton
• Kim M. Bolton
• Tonae Y Bolton
• Robert Boltuch, MD
• Brian J Bolwell, MD
• Aziza Tamara Bomani-Bailey, DO
• Philip Edwin Bomeisl III, D.O.
• Riva Desai Bommireddy, MD
• Kayla Marie Bomske, DDS
• Sarah Bon

• Anesthesiology Physician in Cleveland, OH
• Providers in Cleveland, OH by specialty
• Anesthesiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2025; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.