MS. MARY KATHLEEN BOLLES PMHNP
NPI 1124037957
Nurse Practitioner - Psychiatric/Mental Health in Austin, TX
About Ms. Mary Kathleen Bolles Pmhnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
MS. MARY KATHLEEN BOLLES PMHNP (NPI 1124037957) is an individual psychiatric/mental health provider in Austin, Texas, licensed in Texas (521247) and active in the NPI registry since August 2006. She has opted out of Medicare through October 1, 2026.
NPPES Registry Identity
Specialties & Licenses 3
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Opted out of Medicare
Ms. Mary Kathleen Bolles Pmhnp has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from October 1, 2024 through October 1, 2026.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Mary Bolles's NPI number?
The NPI number for Mary Bolles is 1124037957. It was assigned to this individual provider in the NPPES registry on August 8, 2006.
Where is Mary Bolles located?
Mary Bolles practices at 3705 Medical Parkway, #450 Austin Medical Plaza, Austin, TX 78705. The listed phone number is (512) 306-0061.
What is Mary Bolles's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.
Is Mary Bolles enrolled in Medicare?
No. Mary Bolles has opted out of Medicare through October 1, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.
What insurance does Mary Bolles accept?
Health plans from Baylor Scott and White Health Plan, Blue Cross and Blue Shield of Texas, Community Health Choice, Moda Health Plan, Inc. and Oscar Insurance Company and 3 other insurers list Mary Bolles as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Mary Bolles was last updated on October 28, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Ms. Mary Kathleen Bolles, PMHNP · NPI 1124037957
Psychiatric/Mental Health physician in Austin, Texas. Individual provider, active in the CMS NPPES registry since August 8, 2006.
## Identity
- **NPI:** 1124037957 (Entity type: Individual)
- **Enumerated:** August 8, 2006
- **Primary specialty:** Nurse Practitioner - Psychiatric/Mental Health · taxonomy 363LP0808X
- **State license:** 521247 (Texas)
- **Sole proprietor:** No
## Practice location
- **Address:** 3705 MEDICAL PARKWAY, #450, AUSTIN MEDICAL PLAZA, Austin, TX 78705
- **Phone:** (512) 306-0061 · **Fax:** (512) 306-0069
## Medicare
- **Medicare:** Opted out of Medicare (opt-out affidavit on file, in effect through October 1, 2026); services are provided under private contract
## Record status
- **NPPES last updated:** October 28, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1124037957) · Data from the CMS NPPES public registry.