JEFFREY E BOLEK PHD
NPI 1134217532
Psychologist in Beachwood, OH

Active since October 11, 2006Opted out of Medicare · through Apr 1, 2027
21403 CHAGRIN BLVD, BEACHWOOD, OH 44122(216) 346-5673 Get Directions Write a Review

NPPES record last updated: September 17, 2015. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Jeffrey E Bolek Phd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JEFFREY E BOLEK PHD (NPI 1134217532) is an individual psychologist in Beachwood, Ohio, licensed in Ohio (3496) and active in the NPI registry since October 2006. He has opted out of Medicare through April 1, 2027 and remains eligible to order and refer.

NPPES Registry Identity

NPI1134217532
Entity TypeIndividualMale
Primary Taxonomy103T00000X
Provider Legal NameJEFFREY E BOLEKCredential: PHD
Location Address21403 CHAGRIN BLVDBeachwood, OH 44122-5322
Mailing Address21403 Chagrin Blvd, Rm 212Beachwood, OH 44122-5322 · (216) 346-5673
Sole ProprietorNo
Enumeration DateOctober 11, 2006
Last NPPES UpdateSeptember 17, 2015
NPI 1134217532 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPsychologistBehavioral Health & Social Service Providers
Taxonomy Code103T00000X
License Licensed in OH · 3496
Definition
A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Also ListedPsychologist · RehabilitationTaxonomy 103TR0400X · License 3496 (OH)
21403 CHAGRIN BLVD, Beachwood, OH 44122

Other Identifiers 3

Medicaid2057116OH
Medicare PINBOCP79371OH
Medicare PINH135742OH

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Opted out of Medicare

Jeffrey E Bolek Phd 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 April 1, 2017 through April 1, 2027.

Opt-Out Effective DateApril 1, 2017
Opt-Out In Effect ThroughApril 1, 2027Opt-out affidavits renew automatically every two years unless cancelled
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesAn opted-out provider can still order and refer for Medicare patients in the categories marked above, even though their own services are not covered.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
21403 CHAGRIN BLVD
BEACHWOOD, OH 44122
Psychologist (School)
21403 CHAGRIN BLVD, #210
BEACHWOOD, OH 44122
Counselor (Mental Health)
21403 CHAGRIN BLVD
BEACHWOOD, OH 44122
Psychologist (Clinical)
21403 CHAGRIN BLVD, SUITE 210
BEACHWOOD, OH 44122
Psychologist
21403 CHAGRIN BLVD, STE 210
BEACHWOOD, OH 44122
Psychologist
21403 CHAGRIN BLVD, SUITE 210
BEACHWOOD, OH 44122
Psychologist
21403 CHAGRIN BLVD, SUITE 210
BEACHWOOD, OH 44122
Social Worker (Clinical)
21403 CHAGRIN BLVD, SUITE 210
BEACHWOOD, OH 44122

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 Jeffrey Bolek's NPI number?

The NPI number for Jeffrey Bolek is 1134217532. It was assigned to this individual provider in the NPPES registry on October 11, 2006.

Where is Jeffrey Bolek located?

Jeffrey Bolek practices at 21403 Chagrin Blvd, Beachwood, OH 44122. The listed phone number is (216) 346-5673.

What is Jeffrey Bolek's specialty?

The primary specialty registered for this NPI is Psychologist with taxonomy code 103T00000X.

Is Jeffrey Bolek enrolled in Medicare?

No. Jeffrey Bolek has opted out of Medicare through April 1, 2027. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out. The provider remains eligible to order and refer services for Medicare patients.

When was this NPI record last updated?

The NPPES record for Jeffrey Bolek was last updated on September 17, 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.