Crystal Marie Bolser, AGNP is a medicare enrolled "Internal Medicine" in Moline, Illinois. She graduated from nursing school in 2024 and has 1 years of diverse experience with area of expertise as Internal Medicine. Her current practice location is
550 30th Ave Ste 12, Moline, Illinois. You can reach out to her office (for appointments etc.) via phone at
(309) 736-5568.
Crystal Marie Bolser is licensed to practice in Illinois (license number 209031246) and she also participates in the medicare program. She
may accept medicare assignments (which means she may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance) and her NPI Number is 1518785146.
Provider's Profile
| Full Name | Crystal Marie Bolser |
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| Gender | Female |
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| Speciality | Internal Medicine |
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| Experience | 1 Years |
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| Location | 550 30th Ave Ste 12, Moline, Illinois |
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| Accepts Medicare Assignments | May be. She 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:
- Crystal Marie Bolser graduated from nursing school in 2024
NPI Data:
- NPI Number: 1518785146
- Provider Enumeration Date: 10/02/2024
- Last Update Date: 02/06/2025
Medicare PECOS Information:
- PECOS PAC ID: 4880105352
- Enrollment ID: I20250612003739
Medical Identifiers
Medical identifiers for Crystal Marie Bolser such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1518785146 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 363L00000X | Nurse Practitioner | H181589 (Iowa) | Secondary |
| 207R00000X | Internal Medicine | 209031246 (Illinois) | Primary |
Medical Facilities Affiliation
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. Crystal Marie Bolser allows following entities to bill medicare on her behalf.
| Entity Name | Thomas D Ade Md Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1912612771
PECOS PAC ID: 2860867959
Enrollment ID: O20230403000984 |
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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. Crystal Marie Bolser 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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Crystal Marie Bolser, AGNP
Po Box 623,
Walcott, IA 52773-0623
Ph: () - | Crystal Marie Bolser, AGNP
550 30th Ave Ste 12,
Moline, IL 61265-5975
Ph: (309) 736-5568 |
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