JODY ALLISON BOLTON SMITH (M.D.) – Diagnostic Radiology Physician, NPI 1306846076
Diagnostic Radiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,801 DIAGNOSTIC RADIOLOGY in MN
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Provider Addresses for JODY ALLISON BOLTON SMITH (M.D.)
Connecticut Avenue South, Sartell, Stearns County, Minnesota, 5377, United States
SARTELL, MN 563772554
Phone: (320) 257-5595
Fax: (320) 257-5596
Type: Location
PO BOX 7366
SAINT CLOUD, MN 563027366
Phone: (320) 257-5595
Fax: (320) 257-5596
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 2 Open Payments records for all available years, with a total value of $50.
Total Amount is formed as General ($50) + Research ($0) + Ownership ($0) = $50.
Last reported payment date: 2024-04-11 • Largest payer in this snapshot: Inari Medical, Inc. ($31).
Total Amount
$50
General + Research + Ownership
Payments
2
Total payment records
General Amount
$50
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-04-11
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Inari Medical, Inc. | $31 |
| Bard Peripheral Vascular, Inc. | $19 |
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: 2004-07-01
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20040701001188 | I | Diagnostic Radiology | MN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 77067 | Screening mammography | 364 | 364 | $0 |
| 77063 | Screening 3d breast mammography | 348 | 348 | $0 |
| 71045 | X-ray of chest, 1 view | 306 | 295 | $0 |
| 71046 | X-ray of chest, 2 views | 292 | 283 | $0 |
| 70450 | Ct scan head or brain without contrast | 171 | 165 | $0 |
Insurance plans in this area (ZIP 56377)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DIAGNOSTIC RADIOLOGY | MN | 71250 | CT scan chest | 133 | 126 |
| DIAGNOSTIC RADIOLOGY | MN | 73110 | X-ray of wrist, minimum of 3 views | 18 | 18 |
| DIAGNOSTIC RADIOLOGY | MN | 74177 | CT scan of abdomen and pelvis with contrast | 182 | 172 |
| DIAGNOSTIC RADIOLOGY | MN | 93971 | Ultrasound scan of veins of one arm or leg or limited including assessment of compression and functional maneuvers | 46 | 45 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | MN | |
| Physician Assistant | MN | |
| Internal Medicine | MN | |
| Nurse Practitioner | MN | |
| Internal Medicine, Hospitalist, Internal Medicine | PA | |
| Internal Medicine | MN | |
| Internal Medicine | IA | |
| Nurse Practitioner | MN | |
| Family Practice | MN | |
| Nurse Practitioner | MN |
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