Jeffrey P Bolduan, MD is a medicare enrolled "Urology" physician in Goshen, Indiana. He graduated from medical school in 1975 and has 49 years of diverse experience with area of expertise as Urology. He is a member of the group practice Goshen Health System Inc and his current practice location is
1615 Winsted Dr Ste 4, Goshen, Indiana. You can reach out to his office (for appointments etc.) via phone at
(574) 533-8420.
Jeffrey P Bolduan is licensed to practice in Indiana (license number 01030767) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1831278027.
Physician's Profile
Full Name | Jeffrey P Bolduan |
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Gender | Male |
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Speciality | Urology |
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Experience | 49 Years |
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Location | 1615 Winsted Dr Ste 4, Goshen, Indiana |
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Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Jeffrey P Bolduan graduated from medical school in 1975
NPI Data:
- NPI Number: 1831278027
- Provider Enumeration Date: 11/06/2006
- Last Update Date: 04/24/2023
Medicare PECOS Information:
- PECOS PAC ID: 1951473008
- Enrollment ID: I20080707000164
Medical Identifiers
Medical identifiers for Jeffrey P Bolduan such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1831278027 | NPI | - | NPPES |
100112510A | Medicaid | IN | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
208800000X | Urology | 01030767 (Indiana) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Goshen Health System Inc | 4880598572 | 137 |
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. Jeffrey P Bolduan allows following entities to bill medicare on his behalf.
Entity Name | Goshen Health System Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1194772293 PECOS PAC ID: 4880598572 Enrollment ID: O20031124000658 |
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Entity Name | Jeffrey P Bolduan Md Inc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1538320577 PECOS PAC ID: 2668517020 Enrollment ID: O20100310000143 |
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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. Jeffrey P Bolduan 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 |
Jeffrey P Bolduan, MD 1615 Winsted Dr Ste 4, Goshen, IN 46526-4673 Ph: (574) 533-8420 | Jeffrey P Bolduan, MD 1615 Winsted Dr Ste 4, Goshen, IN 46526-4673 Ph: (574) 533-8420 |
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