Individual provider Active NPI

Denis Bolton, D.O.

  • Diagnostic Radiology Physician
  • Los Alamitos, CA
National Provider Identifier
1952493876
Registry record updated Jun 5, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
20A7689 Issued in CA
Practice address
3751 Katella Ave
Los Alamitos, CA 90720-3101
Phone
(714) 826-6400
Fax
(562) 799-3121
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 20A7689 CA Primary

Addresses

Primary practice location

3751 Katella Ave
Los Alamitos, CA 90720-3101

Mailing address

Dept la 21758
Pasadena, CA 91185-1758
Phone (949) 263-8620

Other identifiers 2

IdentifierTypeStateIssuer
020A76890OtherCABS
00AX76890MedicaidCA

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040701001132 CA Practitioner - Diagnostic Radiology 4385621929 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Los Alamitos Radiology Group IncGroup PAC ID 5092718882, 69 clinicians

Practice addresses (Care Compare)

3751 Katella Ave
Los Alamitos, CA 90720-3113
Phone (562) 799-3294

Hospital & facility affiliations

  • Uci Health-Orange Hospital, Orange, CA, CCN 050348
  • Memorialcare Long Beach Medical Center Hospital, Long Beach, CA, CCN 050485
  • La Palma Intercommunity Hospital Hospital, La Palma, CA, CCN 050580

Merit-based Incentive Payment System (MIPS)

Final score
92.29 of 100Reported as group
Quality
90
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A7689CAMDDiagnostic Radiology Physician
7689CAMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Los Alamitos Radiology Group Inc Diagnostic Radiology CurrentSince May 1, 2008 Accepting new patients
Reliant Radiology Medical Group a Professional Corporation Diagnostic Radiology Past Accepting new patients

Locations

3751 Katella Ave
Los Alamitos, CA 90720
Phone (562) 799-3160

Dept LA 21758
Pasadena, CA 91185

Organizations & group practices 2

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 4

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

NPI Registry JSON

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

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212624000000",
    "number": "1952493876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "DEPT LA 21758",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911851758",
            "telephone_number": "949-263-8620",
            "fax_number": "949-263-1639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3751 KATELLA AVE",
            "city": "LOS ALAMITOS",
            "state": "CA",
            "postal_code": "907203101",
            "telephone_number": "714-826-6400",
            "fax_number": "562-799-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLTON",
        "first_name": "DENIS",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2008-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "20A7689",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BS",
            "identifier": "020A76890",
            "state": "CA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00AX76890",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Los Alamitos, CA

Sources for this page

Verify at the official NPI Registry.