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JOSE MIGUEL BOLANOS RIVERA MD
NPI 1629764287
Family Medicine in Nampa, ID

Active since April 14, 2023PECOS Enrolled
9850 W ST LUKES DR STE 290, NAMPA, ID 83687(208) 463-7300(208) 463-7301 Get Directions Write a Review

NPPES record last updated: July 1, 2026. Verified against the NPPES registry weekly; last sync: August 30, 2026.

About Jose Miguel Bolanos Rivera Md NPPES

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

JOSE MIGUEL BOLANOS RIVERA MD (NPI 1629764287) is an individual family medicine provider in Nampa, Idaho, licensed in Idaho (6771731) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS, maintains a secondary practice location in Nampa, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1629764287
Entity TypeIndividualMale
Primary Taxonomy207Q00000X
Provider Legal NameJOSE MIGUEL BOLANOS RIVERACredential: MD
Location Address9850 W ST LUKES DR STE 290Nampa, ID 83687-7912
Mailing Address190 E Bannock StBoise, ID 83712-6241
Phone(208) 463-7300
Fax(208) 463-7301
Sole ProprietorNo
Medical School CMSOtherGraduated 2016
Enumeration DateApril 14, 2023
Last NPPES UpdateJuly 1, 2026
NPPES CertifiedJuly 1, 2026
✔ NPI 1629764287 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in ID · 6771731
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
9850 W ST LUKES DR STE 290, Nampa, ID 83687
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Secondary Practice Location 1

Location 1215 E Hawaii Ave # 140Nampa, ID 83686-6011 · Phone (208) 514-2529 · Fax (208) 375-2217

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jose Miguel Bolanos Rivera Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID840659934
PECOS Enrollment IDI20260715003950
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 83687 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
$81.13 typical visit price
range $52.44 – $160.17
Typical copayment $20.28 (range $13.11 – $40.04)
Most-billed visit code 99203
Established Patient
$93.26 typical visit price
range $16.68 – $130.93
Typical copayment $23.31 (range $4.17 – $32.73)
Most-billed visit code 99214
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 4

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

TAYLOR CHRISTINE DUPLEX FNP-C
Nurse Practitioner (Family)
9850 W ST LUKES DR STE 290
NAMPA, ID 83687
Canyon County (208) 463-7300
SEAN MICHAEL RUTSCHKE
Family Medicine
9850 W ST LUKES DR STE 290
NAMPA, ID 83687
Canyon County (208) 463-7300
SAMONG SOM LCSW
Social Worker (Clinical)
9850 W ST LUKES DR STE 290
NAMPA, ID 83687
Canyon County (208) 463-7300
YVETTE ANGUIANO
Social Worker (Clinical)
9850 W ST LUKES DR STE 290
NAMPA, ID 83687
Canyon County (208) 463-7300

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 Jose Bolanos Rivera's NPI number?

The NPI number for Jose Bolanos Rivera is 1629764287. It was assigned to this individual provider in the NPPES registry on April 14, 2023.

Where is Jose Bolanos Rivera located?

Jose Bolanos Rivera practices at 9850 W St Lukes Dr Ste 290, Nampa, ID 83687. The listed phone number is (208) 463-7300.

What is Jose Bolanos Rivera's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jose Bolanos Rivera enrolled in Medicare?

Yes. Jose Bolanos Rivera is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jose Bolanos Rivera was last updated on July 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.