Mark D Boldt, NP

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

R0901701 Issued in MN

Practice address

2550 University Ave W
Suite 423 South
Saint Paul, MN 55114-1052

Phone

(612) 870-5557

Fax

(612) 870-5857

NPI assigned

Feb 6, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Mngi Digestive Health, P.a.

  • Gastroenterology Physician
  • Minneapolis, MN
  • NPI 1609804541
  Medicare reassignment NPD
• Affiliated Endoscopy Centers, LLC

  • Ambulatory Surgical Clinic/Center
  • Vadnais Heights, MN
  • NPI 1518995513
  NPD (past)
• Community Anesthesia Professionals PLLC

  • Anesthesiology Physician
  • St Paul, MN
  • NPI 1083079750
  NPD (past)

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

{
    "created_epoch": "1139184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193616000000",
    "number": "1922070762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14909",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554140909",
            "telephone_number": "612-870-5557",
            "fax_number": "612-870-5857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 UNIVERSITY AVE W",
            "address_2": "SUITE 423 SOUTH",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551141052",
            "telephone_number": "612-870-5557",
            "fax_number": "612-870-5857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDT",
        "first_name": "MARK",
        "middle_name": "D",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-06",
        "last_updated": "2007-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "MN",
            "license": "R0901701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• McKenzie Bohlig, OTD, OTR/L
• Kristin Joanna Bohn
• Oksana Bohn, M.D.
• Beverly Elizabeth Bohrer, C.F.A.
• Jonathan Peter Boksberger, D.O.
• Sean P Boley, MD
• Nagasantosha Tejaswini Bollepalli, MD
• Anne Marie Boller, M.D.
• Susan J Bollinger-Brown, MSSW, LICSW, LCSW-C
• Corinne E Bolser, CRNA

• Adult Health Nurse Practitioner in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Adult Health Nurse Practitioner in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.