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RICHARD GERALD BOLANOS JR. M.D.
NPI 1225358369
Obstetrics & Gynecology in Saint Louis, MO

Active since June 10, 2010PECOS EnrolledAccepts Medicare Assignment
4352 MANCHESTER AVE, SAINT LOUIS, MO 63110(314) 531-5444(314) 531-0063 Get Directions Write a Review

NPPES record last updated: January 18, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Jan 18, 2022, Dec 2, 2021 (2 updates tracked since 2021).

About Richard Gerald Bolanos Jr. M.d. NPPES

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

RICHARD GERALD BOLANOS JR. M.D. (NPI 1225358369) is an individual obstetrics & gynecology provider in Saint Louis, Missouri, licensed in Missouri (2010020453) and active in the NPI registry since June 2010. He is enrolled in Medicare PECOS and is a graduate of Other (2010).

NPPES Registry Identity

NPI1225358369
Entity TypeIndividualMale
Primary Taxonomy207V00000X
Provider Legal NameRICHARD GERALD BOLANOS JR.Credential: M.D.
Location Address4352 MANCHESTER AVESaint Louis, MO 63110-2138
Mailing Address4352 Manchester AveSaint Louis, MO 63110-2138 · (314) 531-5444 · Fax (314) 531-0063
Phone(314) 531-5444
Fax(314) 531-0063
Sole ProprietorNo
Medical School CMSOtherGraduated 2010
Enumeration DateJune 10, 2010
Last NPPES UpdateJanuary 18, 20222 updates tracked since enumeration
NPPES CertifiedJanuary 18, 2022
✔ NPI 1225358369 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyObstetrics & GynecologyAllopathic & Osteopathic Physicians
Taxonomy Code207V00000X
License✔ Licensed in MO · 2010020453
Definition
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
4352 MANCHESTER AVE, Saint Louis, MO 63110
Open in Google Maps ↗

Other Names 1

Other Name (5)Ricardo G Bolanos M.d.

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan, Ambetter Health and more.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

Richard Gerald Bolanos Jr. M.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.

PECOS PAC ID1052538683
PECOS Enrollment IDI20140805002878
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Richard Bolanos reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Family Care Health Centers
4.8 mi
Federally Qualified Health Center (FQHC)
401 HOLLY HILLS AVE
Saint Louis, MO 63111
  • Reassigned Medicare billing, Missouri enrollment
  • 55 clinicians in this Medicare group
NPI 1508867508 (314) 481-1615

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 63110 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$128.28 typical visit price
range $55.65 – $169.38
Typical copayment $32.07 (range $13.91 – $42.34)
Most-billed visit code 99204
Established Patient
$69.50 typical visit price
range $17.76 – $137.92
Typical copayment $17.37 (range $4.44 – $34.48)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 19

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

FAMILY CARE HEALTH CENTERS
Clinic/Center (Federally Qualified Health Center (FQHC))
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
St. Louis City (314) 481-1616
COLEEN R. JONES WHNP-BC
Nurse Practitioner
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
St. Louis City (314) 531-5444
DR. JAIME ZENGOTITA MD
Family Medicine
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
St. Louis City (314) 531-5444
VICKI SWYERS LCSW
Social Worker (Clinical)
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
St. Louis City (314) 531-5444
DR. HARRY RICHARD SCHARF DENTIST
Dentist
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
St. Louis City (314) 531-5444
VALERIE LATRICE JOHNSON WHNP-BC
Nurse Practitioner (Women's Health)
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
St. Louis City (314) 531-5444
DR. TARA MARIE BUDETTI M.D.
Pediatrics
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
St. Louis City (314) 531-5444
RADHIKA JAIN MD
Internal Medicine
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
St. Louis City (314) 531-5444

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 Richard Bolanos's NPI number?

The NPI number for Richard Bolanos is 1225358369. It was assigned to this individual provider in the NPPES registry on June 10, 2010. The provider is also known as Ricardo G Bolanos M.D..

Where is Richard Bolanos located?

Richard Bolanos practices at 4352 Manchester Ave, Saint Louis, MO 63110. The listed phone number is (314) 531-5444.

What is Richard Bolanos's specialty?

The primary specialty registered for this NPI is Obstetrics & Gynecology with taxonomy code 207V00000X.

Is Richard Bolanos enrolled in Medicare?

Yes. Richard Bolanos 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 Richard Bolanos's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Richard Bolanos reassigns Medicare benefits to Family Care Health Centers (Saint Louis, MO). 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 Richard Bolanos's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Richard Bolanos accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 2 other insurers list Richard Bolanos 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 Richard Bolanos was last updated on January 18, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.