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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

DR. JANNIE MARIA BOLOTNIKOV MD, MPH
NPI 1750039145
Student in an Organized Health Care Education/Training Program in Denver, CO

Active since March 14, 2022PECOS Enrolled
777 BANNOCK ST # MC0108, DENVER, CO 80204(303) 602-5193 Get Directions Write a Review

NPPES record last updated: September 11, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 11, 2026, Sep 3, 2026, Jul 14, 2026 and 2 more (5 updates tracked since 2023).

About Dr. Jannie Maria Bolotnikov Md, Mph NPPES

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

DR. JANNIE MARIA BOLOTNIKOV MD, MPH (NPI 1750039145) is an individual student in an organized health care education/training program in Denver, Colorado, licensed in Colorado (0077058) and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Loyola University Of Chicago, Stritch School Of Medicine (2023).

NPPES Registry Identity

NPI1750039145
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameDR. JANNIE MARIA BOLOTNIKOVCredential: MD, MPH
Location Address777 BANNOCK ST # MC0108Denver, CO 80204-4507
Mailing Address777 Bannock St # Mc0108Denver, CO 80204-4597 · (303) 602-5193
Phone(303) 602-5193
Sole ProprietorNo
Medical School CMSLoyola University Of Chicago, Stritch School Of MedicineGraduated 2023
Enumeration DateMarch 14, 2022
Last NPPES UpdateSeptember 11, 20265 updates tracked since enumeration
NPPES CertifiedSeptember 11, 2026
✔ NPI 1750039145 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
License✔ Licensed in CO · 0077058
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.
Also ListedEmergency MedicineTaxonomy 207P00000X · License 0077058 (CO)
777 BANNOCK ST # MC0108, Denver, CO 80204
Open in Google Maps ↗

Secondary Practice Locations 2

Location 112505 East 16th Aveaurora, CO 80045 · Phone (720) 848-0000
Location 210350 E Dakota AveDenver, CO 80247-1314 · Phone (303) 338-4545

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Jannie Maria Bolotnikov Md, Mph is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID1254897572
PECOS Enrollment IDI20260728001018
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 Reassignments

2

Medicare enrollment records show Jannie Bolotnikov reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

University Physicians Incorporated
1.4 mi
Physical Medicine & Rehabilitation
1224 5TH ST
Denver, CO 80204
  • Reassigned Medicare billing, Colorado enrollment
  • 4,283 clinicians in this Medicare group
NPI 1265689053 (303) 556-2040
Colorado Permanente Medical Group, P.C.
6.7 mi
Internal Medicine
10350 E DAKOTA AVE
Denver, CO 80247
  • Reassigned Medicare billing, Colorado enrollment
  • Medicare enrollment name: Colorado Permanente Medical Group PC
  • 1,715 clinicians in this Medicare group
NPI 1760599724 (303) 338-4545

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

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.

COURTNEY DIANE WHAM
Student in an Organized Health Care Education/Training Program
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
MICHAEL AAMLI BERGAMINI
Emergency Medicine
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
DR. NICHOLOS POOTHULLIL JOSEPH MD
Student in an Organized Health Care Education/Training Program
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
HANNAH RILEY OBRIEN
Student in an Organized Health Care Education/Training Program
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
ANNA DE SCHUTTER
Student in an Organized Health Care Education/Training Program
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
DOMINIQUE ALEXIS WILLIAMS
Student in an Organized Health Care Education/Training Program
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
MARY MARGARET RYAN MD
Emergency Medicine
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193
TANNER MUGGLI MD
Student in an Organized Health Care Education/Training Program
777 BANNOCK ST # MC0108
DENVER, CO 80204
Denver County (303) 602-5193

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 Jannie Bolotnikov's NPI number?

The NPI number for Jannie Bolotnikov is 1750039145. It was assigned to this individual provider in the NPPES registry on March 14, 2022.

Where is Jannie Bolotnikov located?

Jannie Bolotnikov practices at 777 Bannock St # Mc0108, Denver, CO 80204. The listed phone number is (303) 602-5193.

What is Jannie Bolotnikov's specialty?

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

Is Jannie Bolotnikov enrolled in Medicare?

Yes. Jannie Bolotnikov is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Jannie Bolotnikov's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jannie Bolotnikov reassigns Medicare benefits to 2 organizations: University Physicians Incorporated (Denver, CO) and Colorado Permanente Medical Group, P.C. (Denver, CO). Each 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 Jannie Bolotnikov's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Jannie Bolotnikov was last updated on September 11, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 47 days 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.