BOLIVAR FAMILY MEDICAL CLINIC A MEDICAL CORPORATION
NPI 1215991534
Specialist in Riverside, CA
About Bolivar Family Medical Clinic A Medical Corporation NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BOLIVAR FAMILY MEDICAL CLINIC A MEDICAL CORPORATION (NPI 1215991534) is a healthcare organization registered as a specialist in Riverside, California and active in the NPI registry since April 2006. The organization holds a CLIA Waiver certificate valid through January 22, 2028 and lists Alvaro Bolivar, Co-owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Other Identifiers 4
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bolivar Family Medical Clinic A Medical Corporation is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
5Medicare enrollment records show 5 clinicians reassign Medicare billing to Bolivar Family Medical Clinic A Medical Corporation, which bills Medicare for the services they deliver. They are listed nearest first.
Clinicians, nearest first (5)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate of Waiver 05D1021507
Bolivar Family Medical Clinic · Riverside, CAFrequently 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 Bolivar Family Medical Clinic A Medical Corporation's NPI number?
The NPI number for Bolivar Family Medical Clinic A Medical Corporation is 1215991534. It was assigned to this organization in the NPPES registry on April 13, 2006.
Where is Bolivar Family Medical Clinic A Medical Corporation located?
Bolivar Family Medical Clinic A Medical Corporation is located at 10327 Hole Ave, Riverside, CA 92505. The listed phone number is (951) 351-1600.
What is Bolivar Family Medical Clinic A Medical Corporation's specialty?
The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.
Is Bolivar Family Medical Clinic A Medical Corporation enrolled in Medicare?
Yes. Bolivar Family Medical Clinic A Medical Corporation is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Bolivar Family Medical Clinic A Medical Corporation?
According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians reassign their Medicare billing to Bolivar Family Medical Clinic A Medical Corporation, in Emergency Medicine, Family Practice and Nurse Practitioner. A 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 the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Bolivar Family Medical Clinic A Medical Corporation hold a CLIA laboratory certificate?
Yes. A Certificate of Waiver (number 05D1021507) is associated with this NPI, valid through January 22, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
When was this NPI record last updated?
The NPPES record for Bolivar Family Medical Clinic A Medical Corporation was last updated on January 2, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.
# Bolivar Family Medical Clinic A Medical Corporation · NPI 1215991534
Specialist organization in Riverside, California. Organization record, active in the CMS NPPES registry since April 13, 2006.
## Identity
- **NPI:** 1215991534 (Entity type: Organization)
- **Enumerated:** April 13, 2006
- **Primary specialty:** Specialist · taxonomy 174400000X
- **Organization subpart:** No
- **Authorized official:** Alvaro Bolivar, CO-OWNER
## Practice location
- **Address:** 10327 HOLE AVE, Riverside, CA 92505-1747
- **Phone:** (951) 351-1600 · **Fax:** (951) 351-9400
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 5 clinicians in 3 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (2), Nurse Practitioner (2), Emergency Medicine (1) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** January 2, 2014
- **Other identifiers:** Medicare UPIN A88452 (CA); Medicaid 00A532860 (CA); Medicare PIN ZZZ19987Z (CA); and 1 more
- **CLIA laboratory certificates:** 1 on file
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Source: [NPI Profile](https://npiprofile.com/npi/1215991534) · Data from the CMS NPPES public registry.