MICHAEL BOLANOS M.D.
NPI 1063708600
Thoracic Surgery (Cardiothoracic Vascular Surgery) in Fort Lauderdale, FL
NPI Status: Active since June 22, 2011
Contact Information
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
Phone: (954) 355-4665
Fax: (954) 355-4881
- Individual
- Male
- Years of Experience 15
- Thoracic Surgery (Cardiothoracic Vascula...
- Accepts Insurance
- Accepts Medicare Approved Payment
- PECOS Enrolled
About MICHAEL BOLANOS
This page provides the complete NPI Profile along with additional information for Michael Bolanos, a provider established in Fort Lauderdale, Florida with a medical specialization in Thoracic Surgery (cardiothoracic Vascular Surgery) and more than 15 years of experience. He graduated from Ponce School Of Medicine in 2011. The healthcare provider is registered in the NPI registry with number 1063708600 assigned on June 2011. The practitioner's primary taxonomy code is 208G00000X with license number ME139818 (FL). The provider is registered as an individual and his NPI record was last updated July 2025.
- NPI
- 1063708600
- Provider Name
- MICHAEL BOLANOS M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 1625 SE 3RD AVE STE 300 FORT LAUDERDALE, FL 33316
- Location Phone
- (954) 355-4665
- Location Fax
- (954) 355-4881
- Mailing Address
- 1608 SE 3RD AVE FL 3 FORT LAUDERDALE, FL 33316
- Mailing Phone
- (954) 355-4665
- Mailing Fax
- (954) 355-4881
- Medical School Name
- PONCE SCHOOL OF MEDICINE
- Graduation Year
- 2011
- Is Sole Proprietor?
- No
- Enumeration Date
- 06-22-2011
- Last Update Date
- 07-07-2025
- Code Navigator
Location Map
Secondary Locations
- 1625 SE 3rd Ave Ste 355
Fort Lauderdale, FL 33316
(954) 355-5001 - 1350 Hickory St
Melbourne, FL 32901
(321) 434-3455
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Thoracic Surgery (Cardiothoracic Vascular Surgery)
- Taxonomy Code
- 208G00000X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- ME139818
- License State
- FL
- Taxonomy Description
- A thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
---|---|---|---|---|
1 | 208G00000X | Allopathic & Osteopathic Physicians | Thoracic Surgery (Cardiothoracic Vascular Surgery) | R3392 (KY) |
2 | 390200000X | Student, Health Care | Student in an Organized Health Care Education/Training Program |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Bronze 4 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver 10 Advanced: $0 PCP + Aetna network + $0 MinuteClinic + Adult Dental + Vision - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Care 24/7 + Adult Dental+Vision - HMO
- Clear VALUE Silver - HMO
- Complete VALUE Gold - HMO
- Focused VALUE Silver - HMO
- Focused VALUE Silver + Vision + Adult Dental - HMO
- Standard Gold VALUE - HMO
- Standard Silver VALUE - HMO
- Standard Silver VALUE + Vision + Adult Dental - HMO
- Complete Gold - HMO
- Complete Gold + Vision + Adult Dental - HMO
- Complete VALUE Gold - HMO
- Complete VALUE Silver - HMO
- Elite Bronze - HMO
- Elite Bronze + Vision + Adult Dental - HMO
- Elite Silver - HMO
- Elite Silver + Vision + Adult Dental - HMO
- Elite VALUE Bronze - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options - HMO
- Enhanced Diabetes Care Silver with $0 Drug Options + Vision + Adult Dental - HMO
- Everyday Bronze - HMO
- Everyday Bronze + Vision + Adult Dental - HMO
- Everyday Gold - HMO
- Everyday Gold + Vision + Adult Dental - HMO
- Focused Silver - HMO
- Focused Silver + Vision + Adult Dental - HMO
- Focused VALUE Silver - HMO
- Standard Expanded Bronze - HMO
- Standard Expanded Bronze + Vision + Adult Dental - HMO
- Complete Gold - EPO
- Complete Gold + Vision + Adult Dental - EPO
- Elite Bronze - EPO
- Elite Bronze + Vision + Adult Dental - EPO
- Elite Gold - EPO
- Elite Gold + Vision + Adult Dental - EPO
- Elite Silver - EPO
- Elite Silver + Vision + Adult Dental - EPO
- Everyday Bronze - EPO
- Everyday Bronze + Vision + Adult Dental - EPO
- Focused Silver - EPO
- Focused Silver + Vision + Adult Dental - EPO
- Standard Expanded Bronze - EPO
- Standard Expanded Bronze + Vision + Adult Dental - EPO
- Standard Gold - EPO
- Standard Gold + Vision + Adult Dental - EPO
- Standard Silver - EPO
- AvMed Entrust Bronze 600 (2025) - HMO
- AvMed Entrust Bronze 650 (2025) - HMO
- AvMed Entrust Expanded Bronze Standard (2025) - HMO
- AvMed Entrust Gold 125 (2025) - HMO
- AvMed Entrust Gold 125 Dental+Vision (2025) - HMO
- AvMed Entrust Gold Standard (2025) - HMO
- AvMed Entrust Platinum 25 (2025) - HMO
- AvMed Entrust Platinum 25 Dental+Vision (2025) - HMO
- AvMed Entrust Platinum Standard (2025) - HMO
- AvMed Entrust Silver 350 (2025) - HMO
- AvMed Entrust Silver 350 Dental+Vision (2025) - HMO
- AvMed Entrust Silver 550 (2025) - HMO
- AvMed Entrust Silver 550 Dental+Vision (2025) - HMO
- AvMed Entrust Silver Standard (2025) - HMO
- Bronze 4 - HMO
- Bronze 8 - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Silver 9 - HMO
- Bronze Classic 4700 - EPO
- Bronze Classic Standard - EPO
- Bronze Elite + PCP Saver Plus - EPO
- Gold Classic Standard - EPO
- Gold Elite - EPO
- Gold Elite Saver Plus - EPO
- Secure - EPO
- Silver Classic Standard - EPO
- Silver Elite - EPO
- Silver Simple Chronic Care CKM - EPO
- Silver Simple Diabetes - EPO
- Silver Simple PCP Saver - EPO
- UHC Bronze Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care) - HMO
- UHC Bronze Standard - HMO
- UHC Bronze Value ($0 Virtual Urgent Care) - HMO
- UHC Gold Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
- UHC Gold Copay Focus $0 Indiv Med Ded ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- UHC Gold Standard - HMO
- UHC Silver Advantage ($0 Virtual Urgent Care, $1 Tier 2 Rx) - HMO
- UHC Silver Advantage+ ($0 Virtual Urgent Care, $1 Tier 2 Rx, Dental + Vision) - HMO
- UHC Silver Standard - HMO
- UHC Silver Value ($0 Virtual Urgent Care, $3 Tier 2 Rx) - HMO
- Wellpoint Essential Bronze 5500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 5500 Adult Dental/Vision ($0 Virtual PCP+$0 Select Drugs+Incentives) - HMO
- Wellpoint Essential Bronze 6000 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Bronze 7500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
- Wellpoint Essential Catastrophic 9200 (+ Incentives) - HMO
- Wellpoint Essential Gold 1400 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 1500 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
- Wellpoint Essential Gold 800 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Gold 800 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 1850 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 3500 Adult Dental/Vision ($0 Virtual PCP + $0 Select Drugs + Incentives) - HMO
- Wellpoint Essential Silver 5000 ($0 Virtual PCP + $0 Select Drugs + Incentives) Standard - HMO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
Identifier | Type / Code | Identifier State | Identifier Issuer |
---|---|---|---|
Q01047319 | OTHER (01) | FL | MEDICARE RR |
UP666 | OTHER (01) | FL | MEDICARE HF |
103651500 | MEDICAID (05) | FL |
Medicare Participation & PECOS Enrollment Status
Michael Bolanos is registered with Medicare and accepts claims assignment, this means the provider accepts the approved amount for the cost of rendered services as full payment. Participating providers may not charge beneficiaries more than the approved amount for their services. Please keep in mind that beneficiaries still have to pay a coinsurance or copayment amount for a visit or service.
Michael Bolanos is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
PECOS PAC ID: 6103134259
What is the PECOS Associate Control ID?
A PAC ID is a unique 10-digit number assigned to an individual or organization healthcare provider in PECOS. The PAC ID is used to link together all the provider information, like tax identification numbers and organizational names. A PAC ID can be connected to multiple Enrollment IDs if an individual or organization has enrolled in PECOS more than once.PECOS Enrollment ID: I20190621000361
What is the Provider Enrollment ID?
The Enrollment ID is a unique alphanumeric 15-digit code assigned to each new provider's PECOS enrollment application. The Enrollment ID is used to link together all the provider enrollment information like enrollment type, state, provider specialty, and reassignment of benefits.Accepts Medicare Assignment? Yes
What does it mean "accepts medicare assignment"?
When a provider accepts Medicare assignment, the provider agrees to be paid directly by Medicare and to accept the payment amount approved by Medicare. Additionally, the provider agrees to not bill patients for more than the Medicare deductible and coinsurance amounts.
A provider who doesn't accept assignment may charge you up to 15% over the Medicare-approved amount. This is known as the limiting charge. You may have to pay this amount, or it may be covered by another insurer.Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Coronary artery bypass graft (CABG)
Replacement of aortic valve through the skin and femoral artery
Coronary artery bypass graft (CABG) is a surgery to improve blood flow to your heart. It involves taking a blood vessel from another part of your body and using it to reroute blood around a blocked or narrowed artery in your heart. This can help reduce chest pain and minimize the risk of heart attacks.
This service was performed for 23 patientsThis procedure, known as Transcatheter Aortic Valve Replacement (TAVR), involves replacing a damaged aortic valve through a small incision in the leg. A catheter is inserted into the femoral artery and guided up to the heart. The new valve is then positioned and deployed, restoring normal blood flow.
This service was performed 25 times for 25 patientsPhysician Visit Costs
The typical physician office visit costs for Medicare beneficiaries in this area are: $44.76 for a new patient copayment and $18.25 for an established patient copayment.
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 33316 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99205
- Average New Patient Price $179.05
- Minimum New Patient Price $58.56
- Maximum New Patient Price $179.05
- Average New Patient Copayment $44.76
- Minimum New Patient Copayment $14.64
- Maximum New Patient Copayment $44.76
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99213
- Average Established Patient Price $73
- Minimum Established Patient Price $18.44
- Maximum Established Patient Price $144.68
- Average Established Patient Copayment $18.25
- Minimum Established Patient Copayment $4.61
- Maximum Established Patient Copayment $36.17
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Find Provider Hospital Affiliations - Privileges
Doctors and physicians must apply for hospital privileges to treat patients at hospitals. Find out if your doctor has privileges to practice at your preferred hospital by using the hospital affiliation information below based on recent medical claims.
Hospital affiliation is identified through self-reporting data, inpatient, outpatient, physician and ancillary service claims linked by the medical claims NPI number and place of service code. Additionally, to further determine provider hospital affiliation the clinician must have provided services to at least three patients on three different dates in the last 12 months. Michael Bolanos is affiliated with the following medical facilities:
Hospital Name | Address | Phone | Hospital Type | Overall Rating |
---|---|---|---|---|
HOLMES REGIONAL MEDICAL CENTER | 1350 S HICKORY ST MELBOURNE, FL 32901 | (321) 434-7000 | Acute Care Hospitals |
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
1 | 0 | 6 | 3 | 7 | 0 | 8 | 6 | 0 | 0 |
Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
2 | 0 | 12 | 3 | 14 | 0 | 16 | 6 | 0 | |
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
2 + 0 + 1 + 2 + 3 + 1 + 4 + 0 + 1 + 6 + 6 + 0 + 24 = 50 | |||||||||
Step 3: because the number obtained in step 2 ends in zero, the check digit is zero. | |||||||||
0 |
The NPI number 1063708600 is valid because the calculated check digit 0 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 12 providers are registered at the same or nearby location.
KAREN CALCANO P.A.
Physician Assistant
(Surgical)
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
VIOLETA ATANASOSKI MCCORMACK MD
Internal Medicine
(Interventional Cardiology)
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
MR. JACK JOSEPH CRISTIANO JR. PA-C
Physician Assistant
(Surgical)
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
BRET LESLIE SHARF PA-C
Physician Assistant
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
ARNOUX BLANCHARD M.D
Internal Medicine
(Cardiovascular Disease)
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
JOHN J ROZANSKI MD
Internal Medicine
(Cardiovascular Disease)
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
RICARDO I VICUNA M.D.
Internal Medicine
(Interventional Cardiology)
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
MRS. ASHLEY LELCHUK PA
Physician Assistant
(Surgical)
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
MR. JONATHAN DAVID GILDIN PA
Physician Assistant
(Medical)
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
MR. EVAN TOBIAS MARKELL PA-C
Physician Assistant
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
ALAN L NIEDERMAN MD
Internal Medicine
(Interventional Cardiology)
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
DR. ALEXANDER G JUSTICZ MD
Thoracic Surgery (Cardiothoracic Vascular Surgery)
1625 SE 3RD AVE STE 300
FORT LAUDERDALE, FL
ZIP 33316
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1063708600, enumerated as an "individual" on June 22, 2011.
The provider is located at 1625 SE 3RD AVE STE 300 FORT LAUDERDALE, FL 33316 and the phone number is (954) 355-4665.
Thoracic Surgery (Cardiothoracic Vascular Surgery) with taxonomy code 208G00000X.
The provider might be accepting Accepts: Aetna CVS Health, Ambetter from Superior. Please consult your insurance carrier or call the provider to verify.
Michael Bolanos is affiliated with: HOLMES REGIONAL MEDICAL CENTER.