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: July 26, 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
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.
4352 MANCHESTER AVE, Saint Louis, MO 63110

Other Names 1

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

Accepted Insurance

Medicare Participation & PECOS CMS

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

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.

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 20

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

Clinic/Center (Federally Qualified Health Center (FQHC))
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
Nurse Practitioner
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
Family Medicine
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
Social Worker (Clinical)
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
Dentist
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
Nurse Practitioner (Women's Health)
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
Pediatrics
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110
Internal Medicine
4352 MANCHESTER AVE
SAINT LOUIS, MO 63110

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.

What insurance does Richard Bolanos accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Arkansas Health & Wellness, Ambetter from Home State Health and Ambetter from Sunflower Health Plan and 3 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.