Pavan Bolla, is a medicare enrolled "General Practice" physician in Yonkers, New York. He graduated from medical school in 2013 and has 12 years of diverse experience with area of expertise as Internal Medicine. His current practice location is
78 Stratton St S, Yonkers, New York. You can reach out to his office (for appointments etc.) via phone at
(914) 787-7400.
Pavan Bolla is licensed to practice in New York (license number P135320) and he also participates in the medicare program. He
may accept medicare assignments (which means he may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and his NPI Number is 1790670834.
Physician's Profile
| Full Name | Pavan Bolla |
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| Gender | Male |
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| Speciality | Internal Medicine |
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| Experience | 12 Years |
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| Location | 78 Stratton St S, Yonkers, New York |
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| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Pavan Bolla graduated from medical school in 2013
NPI Data:
- NPI Number: 1790670834
- Provider Enumeration Date: 06/10/2025
- Last Update Date: 06/10/2025
Medicare PECOS Information:
- PECOS PAC ID: 8921513169
- Enrollment ID: I20250716000665
Medical Identifiers
Medical identifiers for Pavan Bolla such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1790670834 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 208D00000X | General Practice | P135320 (New York) | Primary |
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. Pavan Bolla 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 |
|---|
Pavan Bolla,
3438 Bell Blvd Bay Bayside,
Bayside, NY 11361-1739
Ph: () - | Pavan Bolla,
78 Stratton St S,
Yonkers, NY 10701-5969
Ph: (914) 787-7400 |
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