Kevin Bolanos, DO
Individual provider Active NPI Internal Medicine Physician · Tucson, AZ
NPI 1972096121 · NPPES record last updated Feb 18, 2022
Key facts
- NPI
- 1972096121
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- 009034 (AZ)
- Practice address
- 5301 E Grant Rd
Tucson, AZ 85712-2805 - Phone
- (520) 318-3434
- NPI assigned
- Jun 12, 2018
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Hospital & facility affiliations 5
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Touro Un Col of Osteopathic Medicine, Henderson, 2018
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Arizona Inpatient Medicine Associates LLC
Practice addresses (Care Compare)
7383 E Tanque Verde Rd
Tucson, AZ 85715-3475
Phone (520) 318-3434
Hospital & facility affiliations
- Tucson Medical Center
- Oro Valley Hospital
- Northwest Medical Center Sahuarita
- Benson Hospital
- Northern Cochise Community Hospital, Inc.
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in AZ
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20211013002007 | AZ | Practitioner - Internal Medicine |
5698173136 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Osteopathy
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Arizona Inpatient Medicine Associates LLC | Internal Medicine | Current |
Accepting new patients |
Locations
7383 E Tanque Verde Rd
Tucson, AZ 85715
Phone (520) 318-3434
5301 E Grant Rd
Tucson, AZ 85712
Phone (520) 324-1344
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 009034 | AZ | Yes |
Addresses
Primary practice location
5301 E Grant Rd
Tucson, AZ 85712-2805
Mailing address
265 Mesa Trail Dr
Sierra Vista, AZ 85635-4436
Phone (858) 361-7198
Other providers in Tucson, AZ
- Terri Boitano
- Ivan Bojorquez Cejudo
- Alexa Bojorquez
- Virginia Anne Boland-Robillard
- Andria Rae Boland
- Brenda Marie Boldrey
- Patricia Bolhack
- Scott M Bolhack
- Misty Boling
- Mary E Boll
All providers in Tucson, AZ · Internal Medicine Physician in Arizona
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 18, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.