DR. ALEJANDRO ENRIQUE BOLIVAR (MD) – Family Medicine Physician, NPI 1114669132

DR. ALEJANDRO ENRIQUE BOLIVAR (MD) is a healthcare provider. based in Indianapolis, Indiana. specializing in FAMILY PRACTICE. They hold the professional credentials MD. They hold a License No. 01097660A (IN). The NPI Number for DR. ALEJANDRO ENRIQUE BOLIVAR (MD) is 1114669132

Main info

Male
1 Year Of Experience
Accepts Medicare Assignment
Name
DR. ALEJANDRO ENRIQUE BOLIVAR (MD)
NPI
1114669132
Phone
(317) 963-4634
Address
1520 N SENATE AVE
Enumeration Date
11 April 2022
Last Update Date
9 September 2025

Doctor Profile

Medical School Name
INDIANA UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
3177394848
Graduation Year
2025 (1 year ago)
PAC ID
7911379441
Group Practice PAC ID
8426965039
Professional Enrollment ID
I20260120001402
Address ID
IN461317308FR55XXXDRXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience37
Completeness85
Years active:4State licenses:1Digital endpointsOther names

2,861 FAMILY PRACTICE in IN

Provider Addresses for DR. ALEJANDRO ENRIQUE BOLIVAR (MD)

  • 1520 N SENATE AVE

    INDIANAPOLIS, IN 462022213

    Phone: (317) 963-4634

    Type: Mailing

  • 55 N MILFORD DR

    FRANKLIN, IN 461317308

    Phone: (317) 648-7169

    Type: Mailing

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: 2026-01-20

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
I20260120001402IFamily PracticeINTBD

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.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 46202)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426965039View full group profile
NameSpecialtyState
Internal MedicineIN
Family PracticeIN
-IN
Family PracticeIN
-IN
Nurse PractitionerIN
Family PracticeIN
Mental Health CounselorIN
Clinical Social WorkerIN
Family PracticeIN

Reviews

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Frequently asked questions

What unique ID ties claims to DR. ALEJANDRO ENRIQUE BOLIVAR (MD)?
NPI 1114669132 is assigned to DR. ALEJANDRO ENRIQUE BOLIVAR (MD) under the national enumeration system.
Is DR. ALEJANDRO ENRIQUE BOLIVAR (MD)'s NPI currently valid?
The extract we use shows DR. ALEJANDRO ENRIQUE BOLIVAR (MD) as active.
What does DR. ALEJANDRO ENRIQUE BOLIVAR (MD) treat or focus on?
Patients typically see DR. ALEJANDRO ENRIQUE BOLIVAR (MD) under the specialty Family Medicine Physician. Clinical services aligned with this taxonomy classification.
Where does public data place DR. ALEJANDRO ENRIQUE BOLIVAR (MD)?
The snapshot lists Indianapolis, Indiana for DR. ALEJANDRO ENRIQUE BOLIVAR (MD); download NPPES for the complete set.
Is DR. ALEJANDRO ENRIQUE BOLIVAR (MD) a real provider?
This page reflects official NPPES data for NPI 1114669132. Always confirm identity and privileges with the practice and licensing boards.

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