LAURA BOLT (PA-C) – Physician Assistant, NPI 1124438205
Physician Assistant
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Doctor Profile
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Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for LAURA BOLT (PA-C)
PO BOX 3158
PORTLAND, OR 972083158
Phone: (503) 215-2300
Type: Mailing
4805 NE GLISAN ST
STE 6N50
PORTLAND, OR 972132933
Phone: (503) 215-2300
Fax: (503) 215-8004
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: 2020-04-09
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
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 |
|---|---|---|---|---|
| I20150930003417 | I | Physician Assistant | OR | TBD |
| I20200409001637 | I | Physician Assistant | WA | 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 |
|---|---|---|---|---|
| 99285 | Emergency department visit with high level of medical decision making | 39 | 39 | $0 |
| 99284 | Emergency department visit with moderate level of medical decision making | 23 | 23 | $0 |
| 93010 | Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report only | 19 | 18 | $0 |
Insurance plans in this area (ZIP 97208)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pulmonary Disease, Internal Medicine | OR | |
| - | OR | |
| - | OR | |
| - | OR | |
| Pain Management | CA | |
| - | OR | |
| Internal Medicine | OR | |
| - | OR | |
| Plastic And Reconstructive Surgery | OR | |
| - | OR |
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