EDGAR B JR. BOLTON (DO) – Pulmonary Disease Physician, NPI 1487635462

EDGAR B JR. BOLTON (DO) is a healthcare provider. based in Fort lauderdale, Florida. specializing in Pulmonary Disease Physician. They hold the professional credentials DO. They hold a License No. OS2458 (FL). The NPI Number for EDGAR B JR. BOLTON (DO) is 1487635462

Main info

Male
Sole Proprietor
57 Years Of Experience
Accepts Medicare Assignment
Name
EDGAR B JR. BOLTON (DO)
NPI
1487635462
Phone
(954) 445-1754
Address
1512 SE 10TH ST
Enumeration Date
8 November 2005
Last Update Date
11 February 2016

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
-
Graduation Year
1969 (57 years ago)
PAC ID
4486623436
Professional Enrollment ID
I20040928000140
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for EDGAR B JR. BOLTON (DO)

  • 1512, Southeast 10th Street, Rio Vista Isles, Fort Lauderdale, Broward County, Florida, 33316, United States

    FORT LAUDERDALE, FL 333161420

    Phone: (954) 445-1754

    Fax: (954) 766-8199

    Type: Mailing

  • 1900, North University Drive, Pembroke Pines, Broward County, Florida, 33024, United States

    SUITE 107

    PEMBROKE PINES, FL 330243618

    Phone: (954) 441-1616

    Fax: (954) 766-8199

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2004-09-28

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20040928000140IPulmonary DiseaseFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes33020$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes2422$0
View full utilization report →

Insurance plans in this area (ZIP 33316)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for EDGAR B JR. BOLTON (DO)?
EDGAR B JR. BOLTON (DO) — NPI 1487635462 — is the standard way to identify this listing.
Does the file indicate EDGAR B JR. BOLTON (DO) is practicing under active NPI?
Directory data currently reports EDGAR B JR. BOLTON (DO) as active.
What taxonomy line describes EDGAR B JR. BOLTON (DO)?
For research purposes, treat EDGAR B JR. BOLTON (DO) as Pulmonary Disease Physician in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for EDGAR B JR. BOLTON (DO)?
EDGAR B JR. BOLTON (DO)'s geographic hint is Fort Lauderdale, Florida in our summary view.
Is the information about EDGAR B JR. BOLTON (DO) up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

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