MR. RYAN MABE BOLT PMHNP-BC, FNP-C
NPI 1639679822
Nurse Practitioner - Psychiatric/Mental Health in San Diego, CA

Q: What is Ryan Bolt's NPI number?

The NPI number for Ryan Bolt is 1639679822. It was assigned to this individual provider in the NPPES registry on February 14, 2018.

Q: What is Ryan Bolt's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Q: When was this NPI record last updated?

The NPPES record for Ryan Bolt was last updated on November 2, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.

Active since February 14, 2018PECOS Enrolled

10620 TREENA ST STE 230, SAN DIEGO, CA 92131(858) 609-9763(504) 290-1145 Get Directions Write a Review

NPPES record last updated: November 2, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Nov 2, 2023, Dec 30, 2020, Feb 14, 2018 (3 updates tracked since 2018).

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About Mr. Ryan Mabe Bolt Pmhnp-bc, Fnp-c NPPES

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

MR. RYAN MABE BOLT PMHNP-BC, FNP-C (NPI 1639679822) is an individual psychiatric/mental health provider in San Diego, California, licensed in California (95008584) and active in the NPI registry since February 2018. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1639679822

Entity TypeIndividualMale

Primary Taxonomy363LP0808X

Provider Legal NameMR. RYAN MABE BOLTCredential: PMHNP-BC, FNP-C

Location Address10620 TREENA ST STE 230San Diego, CA 92131-1140

Mailing Address10620 Treena St Ste 230San Diego, CA 92131-1140 · (208) 850-6422

Phone(858) 609-9763

Fax(504) 290-1145

Sole ProprietorNo

Enumeration DateFebruary 14, 2018

Last NPPES UpdateNovember 2, 20233 updates tracked since enumeration

NPPES CertifiedNovember 2, 2023

✔ NPI 1639679822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LP0808X

License✔ Licensed in CA · 95008584

Also ListedNurse Practitioner · FamilyTaxonomy 363LF0000X · License 95008584 (CA)

10620 TREENA ST STE 230, San Diego, CA 92131

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mr. Ryan Mabe Bolt Pmhnp-bc, Fnp-c is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 92131 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

$94.87 typical visit price

range $62.10 – $184.71

Typical copayment $23.71 (range $15.52 – $46.17)

Most-billed visit code 99203

Established Patient

$108.42 typical visit price

range $20.62 – $151.42

Typical copayment $27.10 (range $5.15 – $37.85)

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 20

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

DANIJELA MUDRI-NICIN

Marriage & Family Therapist