Brent Bolyard, MD is a medicare enrolled "Psychiatry & Neurology - Psychiatry" physician in Brighton, Missouri. His current practice location is
1620 W State Highway Cc, Brighton, Missouri. You can reach out to his office (for appointments etc.) via phone at
(330) 663-1583.
Brent Bolyard is licensed to practice in Arkansas (license number E-4507) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1154341568.
Physician's Profile
| Full Name | Brent Bolyard |
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| Gender | Male |
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| Speciality | Psychiatry & Neurology - Psychiatry |
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| Location | 1620 W State Highway Cc, Brighton, Missouri |
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| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1154341568
- Provider Enumeration Date: 07/20/2006
- Last Update Date: 01/02/2017
Medicare PECOS Information:
- PECOS PAC ID: 9234157017
- Enrollment ID: I20051110000142
Medical Identifiers
Medical identifiers for Brent Bolyard such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1154341568 | NPI | - | NPPES |
| 158495001 | Medicaid | AR | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 2084P0800X | Psychiatry & Neurology - Psychiatry | E-4507 (Arkansas) | Primary |
| 2084P0804X | Psychiatry & Neurology - Child & Adolescent Psychiatry | E-4507 (Arkansas) | Secondary |
| 2084P0805X | Psychiatry & Neurology - Geriatric Psychiatry | E-4507 (Arkansas) | Secondary |
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. Brent Bolyard allows following entities to bill medicare on his behalf.
| Entity Name | Texarkana Behavioral Associates Lc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1467483677 PECOS PAC ID: 9436062379 Enrollment ID: O20040223000353 |
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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. Brent Bolyard 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 |
Brent Bolyard, MD 1620 W State Highway Cc, Brighton, MO 65617-9427 Ph: (330) 663-1583 | Brent Bolyard, MD 1620 W State Highway Cc, Brighton, MO 65617-9427 Ph: (330) 663-1583 |
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