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ZACHARY BOLTE
NPI 1679213946
Student in an Organized Health Care Education/Training Program in Livonia, MI

Active since April 01, 2022PECOS Enrolled
ST MARY MERCY HOSPITAL, 36475 FIVE MILE ROAD, LIVONIA, MI 48154(734) 655-4800(734) 655-2911 Get Directions Write a Review

NPPES record last updated: April 1, 2022. Verified against the NPPES registry weekly; last sync: November 08, 2026.

About Zachary Bolte NPPES

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

ZACHARY BOLTE (NPI 1679213946) is an individual student in an organized health care education/training program in Livonia, Michigan and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS, is affiliated with Samaritan Lebanon Community Hospital, and is a graduate of Oregon Health Sciences University School Of Medicine (2022).

NPPES Registry Identity

NPI1679213946
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameZACHARY BOLTE
Location AddressST MARY MERCY HOSPITAL, 36475 FIVE MILE ROADLivonia, MI 48154
Mailing AddressSt. Mary Mercy Hospital, 36475 Five Mile RoadLivonia, MI 48154 · (734) 655-4800 · Fax (734) 655-2911
Phone(734) 655-4800
Fax(734) 655-2911
Sole ProprietorYes
Medical School CMSOregon Health Sciences University School Of MedicineGraduated 2022
Enumeration DateApril 1, 2022
NPPES CertifiedMarch 21, 2022
✔ NPI 1679213946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
ST MARY MERCY HOSPITAL, Livonia, MI 48154
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Zachary Bolte is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID4789065459
PECOS Enrollment IDI20260807001240
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 Zachary Bolte reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Mid-Valley Healthcare, Inc.
1,972 mi
Rural Health
1289 49TH AVE STE 102
Sweet Home, OR 97386
  • Reassigned Medicare billing, Oregon enrollment
  • 416 clinicians in this Medicare group
NPI 1528334125 (541) 451-6250

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Samaritan Lebanon Community Hospital

Critical Access Hospitals · Lebanon, OR
2/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number381323
Location525 N Santiam HighwayLebanon, OR 97355 · Linn County
Emergency services Birthing friendly

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 Zachary Bolte's NPI number?

The NPI number for Zachary Bolte is 1679213946. It was assigned to this individual provider in the NPPES registry on April 1, 2022.

Where is Zachary Bolte located?

Zachary Bolte practices at St Mary Mercy Hospital 36475 Five Mile Road, Livonia, MI 48154. The listed phone number is (734) 655-4800.

What is Zachary Bolte's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Zachary Bolte enrolled in Medicare?

Yes. Zachary Bolte is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Zachary Bolte's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Zachary Bolte reassigns Medicare benefits to Mid-Valley Healthcare, Inc. (Sweet Home, OR). 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 Zachary Bolte's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Zachary Bolte affiliated with any hospitals?

According to CMS data, Zachary Bolte is affiliated with Samaritan Lebanon Community Hospital.

When was this NPI record last updated?

The NPPES record for Zachary Bolte was last updated on April 1, 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.