Alice Nelly Bolick, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA22868 Issued in CA

Practice address

7031 Koll Center Pkwy Ste 100
Pleasanton, CA 94566-3137

Phone

(925) 469-9120

NPI assigned

May 1, 2013

Last updated

Nov 12, 2024By the provider in NPPES

Sex

Female

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 CA

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

Physician Assistant

State licenses

Practice roles

Locations

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.

• Bass Medical Group

  • Obstetrics & Gynecology Physician
  • Walnut Creek, CA
  • NPI 1174253405
  Medicare reassignment NPD
• Integrated Pain Management Medical Group, Inc.

  dba Boomerang Healthcare

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Walnut Creek, CA
  • NPI 1922198779
  Medicare reassignment
• Bass Medical Group

  • Orthopaedic Surgery Physician
  • San Ramon, CA
  • NPI 1467329904
  NPD
• Bass Medical Group

  • Specialist
  • Walnut Creek, CA
  • NPI 1154401941
  NPD (past)
• Bass Medical Group

  • Pain Medicine Physician
  • Visalia, CA
  • NPI 1326409343
  NPD (past)
• Navin Mallavaram, M.D., Inc.

  • Interventional Pain Medicine Physician
  • Pleasanton, CA
  • NPI 1164708582
  NPD (past)

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

{
    "created_epoch": "1367366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1922443167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7031 KOLL CENTER PKWY STE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945663137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7031 KOLL CENTER PKWY STE 100",
            "city": "PLEASANTON",
            "state": "CA",
            "postal_code": "945663137",
            "telephone_number": "925-469-9120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLICK",
        "first_name": "ALICE",
        "middle_name": "NELLY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-01",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA22868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bodymax Physical Therapy Inc
• Bodymax Physical Therapy, Inc.
• Mary Joy Bodzioch, PH.D.
• Jenna Marie Boeger
• Maren Bohne, FNP
• Helen Jo Bonds
• Paul Bonnel
• Michelle Bonnelly-Juarbe, SLP-CCC
• Boom Investments, Inc. (Pro Care Medical Supplies)
• Vandana Boparai, MD

• Physician Assistant in Pleasanton, CA
• Providers in Pleasanton, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 12, 2024; 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.