Deactivated NPI 1376522672 Deactivated / Inactive NPI Male Practitioner

Jeffrey Lynn Boldt , PA

Physician Assistant • Wall Lake, IA

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Jeffrey Boldt has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date January 13, 2006

NPI Deactivation Date February 01, 2023

Total Practice Duration ~17 Years of Practice (2006 – 2023)

Professional Overview & Biography Verified Profile Summary

Jeffrey Boldt, PA was a registered Physician Assistant practicing in Wall Lake, IA. Throughout an active medical career spanning 17 years, Jeffrey Boldt provided care at the practice location at 311 W 1ST ST until profile deactivation on 2023-02-01.

Historical Medicare Part B clinical services included established patient outpatient office visit, subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

311 W 1st St

Wall Lake, IA 514667014

Telephone 7126648200

Fax 7126642820

Associated Practice Facility / Clinic

🏢 St Anthony Wall Lake Pharmacy Facility NPI 1821161936

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Wall Lake, IA

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 10.5 Yrs

State Avg: 13.7 Yrs

Regional Practice Density

1 Specialists

Practicing in Wall Lake, IA (1543 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

23.2% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2022)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	14	14	$71.00	$54.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	197	157	$62.58	$54.66
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	37	14	$86.05	$35.53
99308 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 15 minutes	23	17	$134.09	$55.57
99213 Established patient office or other outpatient visit, typically 15 minutes	23	21	$78.13	$51.42
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	19	17	$83.00	$81.41

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	155	120	$54.00	$42.25
99307 Subsequent nursing facility care with straightforward level of medical decision making, per day, if using time, at least 10 minutes	26	14	$84.00	$36.07
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	24	22	$27.00	$21.12
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	15	$83.00	$65.21
99213 Established patient office or other outpatient visit, typically 15 minutes	13	13	$74.08	$38.52

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	29	21	$72.37	$44.15

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	36	21	$69.10	$41.88

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	47	22	$66.59	$41.40

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License IA 000691

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

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NPI Profile Deactivated February 01, 2023

Record deactivated on February 01, 2023

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NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 311 W 1ST ST, WALL LAKE, IA 514667014 (Tel: 7126648200)

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Updated Business Mailing Address July 08, 2007

Registered at 311 S CLARK ST, CARROLL, IA 514013038 (Tel: 7127923581)

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Provider Name / Credentials Updated July 08, 2007

Recorded as JEFFREY BOLDT, PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Physician Assistant (License #000691 in IA)

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Initial NPI Registration & Enumeration January 13, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews

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NPI Administrative Meta

NPI Number: 1376522672

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: January 13, 2006

Last Update: July 08, 2007

Deactivation Date: February 01, 2023

Update or Correct Profile

Mailing Address

311 S Clark St

Carroll, IA 514013038

Phone: 7127923581

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.