Ms Mary Kathleen Bolles, PMHNP is a medicare enrolled "Nurse Practitioner - Psychiatric/mental Health" provider in Austin, Texas. Her current practice location is
3705 Medical Parkway, #450, Austin Medical Plaza, Austin, Texas. You can reach out to her office (for appointments etc.) via phone at
(512) 306-0061.
Ms Mary Kathleen Bolles is licensed to practice in Texas (license number 521247) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1124037957.
Healthcare Provider's Profile
| Full Name | Ms Mary Kathleen Bolles |
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| Gender | Female |
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| Speciality | Nurse Practitioner - Psychiatric/mental Health |
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| Location | 3705 Medical Parkway, #450, Austin, Texas |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
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NPI Data:
- NPI Number: 1124037957
- Provider Enumeration Date: 08/08/2006
- Last Update Date: 10/28/2015
Medicare PECOS Information:
- PECOS PAC ID: 5496088114
- Enrollment ID: I20210621000908
Medical Identifiers
Medical identifiers for Ms Mary Kathleen Bolles such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1124037957 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 101YA0400X | Counselor - Addiction (substance Use Disorder) | 13337 (Texas) | Secondary |
| 163WP0809X | Registered Nurse - Psychiatric/mental Health, Adult | 521247 (Texas) | Secondary |
| 363LP0808X | Nurse Practitioner - Psychiatric/mental Health | 521247 (Texas) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Ms Mary Kathleen Bolles allows following entities to bill medicare on her behalf.
| Entity Name | Tms Neurohealth Texas Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1154892230
PECOS PAC ID: 7810227600
Enrollment ID: O20190920000951 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Mary Kathleen Bolles is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Ms Mary Kathleen Bolles, PMHNP
3705 Medical Parkway #450, Austin Medical Plaza,
Austin, TX 78705
Ph: (512) 306-0061 | Ms Mary Kathleen Bolles, PMHNP
3705 Medical Parkway, #450, Austin Medical Plaza,
Austin, TX 78705
Ph: (512) 306-0061 |
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