DR. LEA J BOLDT (PHD) – Psychologist, NPI 1649945114

DR. LEA J BOLDT (PHD) is a healthcare provider. based in Iowa city, Iowa. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 109669 (IA). The NPI Number for DR. LEA J BOLDT (PHD) is 1649945114

Main info

Female
6 Years Of Experience
Accepts Medicare Assignment
Name
DR. LEA J BOLDT (PHD)
NPI
1649945114
Phone
(319) 356-4658
Address
200 HAWKINS DR
Enumeration Date
16 August 2021
Last Update Date
16 September 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3196263300
Graduation Year
2020 (6 years ago)
PAC ID
8820494867
Group Practice PAC ID
8921331836
Professional Enrollment ID
I20210831001194
Address ID
IA523178819NO320XXSTXX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience42
Completeness75
Years active:4State licenses:1Digital endpointsOther names

192 CLINICAL PSYCHOLOGIST in IA

Provider Addresses for DR. LEA J BOLDT (PHD)

  • 200 HAWKINS DR

    IOWA CITY, IA 522421009

    Phone: (319) 356-4658

    Fax: (319) 356-2587

    Mailing address matches the actual address.

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: 2021-08-31

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
I20210831001194IClinical PsychologistIATBD

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 52242)

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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: 8921331836View full group profile
NameSpecialtyState
Clinical Social WorkerIA
Clinical Social WorkerIA
Clinical PsychologistIA
P S Y C H I A T R YIA
Physician AssistantIA
Mental Health CounselorIL
-IA
Clinical Social WorkerIA
Clinical Social WorkerIA
Clinical Social WorkerIA

Reviews

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Frequently asked questions

Does DR. LEA J BOLDT (PHD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. LEA J BOLDT (PHD) uses 1649945114.
Is DR. LEA J BOLDT (PHD) listed as active for patients and plans?
The listing shows DR. LEA J BOLDT (PHD) as active in the NPI system.
What is DR. LEA J BOLDT (PHD)'s primary classification?
Psychologist is the headline specialty for DR. LEA J BOLDT (PHD) here. Clinical services aligned with this taxonomy classification.
Where is DR. LEA J BOLDT (PHD) based?
DR. LEA J BOLDT (PHD) is tied to Iowa City, Iowa in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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