DR. JEREMY VINCENT BOLTON PH.D.
NPI 1215789276
Psychologist - Clinical in Fresno, CA
About Dr. Jeremy Vincent Bolton Ph.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. JEREMY VINCENT BOLTON PH.D. (NPI 1215789276) is an individual clinical provider in Fresno, California, licensed in California (PSY36084) and active in the NPI registry since April 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2019).
NPPES Registry Identity
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Dr. Jeremy Vincent Bolton Ph.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Medicare Billing Reassignment
Medicare enrollment records show Jeremy Bolton reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Gardena, CA 90248
- Reassigned Medicare billing, California enrollment
- 375 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 93704 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 6
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
FRESNO, CA 93704
FRESNO, CA 93704
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 Jeremy Bolton's NPI number?
The NPI number for Jeremy Bolton is 1215789276. It was assigned to this individual provider in the NPPES registry on April 3, 2024.
Where is Jeremy Bolton located?
Jeremy Bolton practices at 516 W Shaw Ave, Fresno, CA 93704. The listed phone number is (559) 803-9613.
What is Jeremy Bolton's specialty?
The primary specialty registered for this NPI is Psychologist, specializing in Clinical, with taxonomy code 103TC0700X.
Is Jeremy Bolton enrolled in Medicare?
Yes. Jeremy Bolton is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
Which organization bills Medicare for Jeremy Bolton's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Jeremy Bolton reassigns Medicare benefits to Ehab Yacoub MD Inc. (Gardena, CA). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Jeremy Bolton's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Jeremy Bolton accept?
Health plans from UnitedHealthcare list Jeremy Bolton 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 Jeremy Bolton was last updated on October 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 months 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.
# Dr. Jeremy Vincent Bolton, PH.D. · NPI 1215789276
Clinical provider in Fresno, California. Individual provider, active in the CMS NPPES registry since April 3, 2024.
## Identity
- **NPI:** 1215789276 (Entity type: Individual)
- **Enumerated:** April 3, 2024
- **Primary specialty:** Psychologist - Clinical · taxonomy 103TC0700X
- **State license:** PSY36084 (California)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 516 W SHAW AVE, Fresno, CA 93704-2515
- **Phone:** (559) 803-9613
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Ehab Yacoub MD Inc. (NPI 1417373713, Gardena, CA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2019
## Record status
- **NPPES last updated:** October 28, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1215789276) · Data from the CMS NPPES public registry.