JESSICA K BOLAND (CRNP) – Family Nurse Practitioner, NPI 1376815241

Family Nurse Practitioner

JESSICA K BOLAND (CRNP) is a healthcare provider. based in South park, Pennsylvania. specializing in NURSE PRACTITIONER. They hold the professional credentials CRNP. They hold a License No. ARNP9264097 (FL). The NPI Number for JESSICA K BOLAND (CRNP) is 1376815241

Main info

Female

Sole Proprietor

15 Years Of Experience

Accepts Medicare Assignment

Name

JESSICA K BOLAND (CRNP)

NPI

1376815241

Phone

(407) 758-3025

Address

2523 BONNIE DELL DR

Enumeration Date

7 February 2012

Last Update Date

3 July 2023

Doctor Profile

Medical School Name

OTHER

Secondary Phone

4123573161

Graduation Year

2011 (15 years ago)

PAC ID

3678735719

Group Practice PAC ID

8729990239

Professional Enrollment ID

I20150417000427

Address ID

PA151462760MO2775XBLVD300

Telehealth

Yes

Data current as of

20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology

Experience61

Completeness75

Years active:14State licenses:2Digital endpointsOther names

11,473 NURSE PRACTITIONER in PA

Provider Addresses for JESSICA K BOLAND (CRNP)

2523 BONNIE DELL DR
SOUTH PARK, PA 151298898
Phone: (407) 758-3025
Type: Mailing
1181 FREEDOM RD
CRANBERRY TOWNSHIP, PA 160664913
Phone: (407) 758-3025
Type: Location
111 TRENTON CIR
CANONSBURG, PA 153173657
Phone: (407) 758-3025
Type: Mailing
3600 FORBES AVE
PITTSBURGH, PA 152133410
Phone: (407) 758-3025
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: 2015-04-17

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

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
I20150417000427	I	Nurse Practitioner	PA	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.

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 15129)

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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: 8729990239View full group profile

Name	Specialty	State
DR. ERIC LOWELL DAVIDSON (M.D.)	Anesthesiology, Critical Care (Intensivists)	PA
CHARMAINE PYKOSH	-	PA
KARLYN RUPERT	-	PA
MR. DEREK RAY SERNA-GALLEGOS (MD)	Cardiac Surgery, General Surgery	PA
STEPHANIE SCHULTZ (CRNP)	Nurse Practitioner	PA
WANDA D RYAN (M.D.)	-	PA
LEISHA EMENS	-	MD
DIANNE JENKINS	-	SC
LAWRENCE MARR	-	PA
BRENT CAIN	-	PA