JEFFREY E BOLEK PHD
NPI 1134217532
Psychologist in Beachwood, OH
NPI Status: Active since October 11, 2006
Contact Information
21403 CHAGRIN BLVD
BEACHWOOD, OH
ZIP 44122
Phone: (216) 346-5673
- Individual
- Male
- Psychologist
- PECOS Enrolled
- Opted-Out Medicare
About JEFFREY BOLEK
This page provides the complete NPI Profile along with additional information for Jeffrey Bolek, a provider established in Beachwood, Ohio with a medical specialization in Psychologist. The healthcare provider is registered in the NPI registry with number 1134217532 assigned on October 2006. The practitioner's primary taxonomy code is 103T00000X with license number 3496 (OH). The provider is registered as an individual and his NPI record was last updated 10 years ago.
- NPI
- 1134217532
- Provider Name
- JEFFREY E BOLEK PHD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 21403 CHAGRIN BLVD BEACHWOOD, OH 44122
- Location Phone
- (216) 346-5673
- Mailing Address
- 21403 CHAGRIN BLVD RM 212 BEACHWOOD, OH 44122
- Mailing Phone
- (216) 346-5673
- Is Sole Proprietor?
- No
- Enumeration Date
- 10-11-2006
- Last Update Date
- 09-17-2015
- Code Navigator
A psychologist like Jeffrey Bolek studies cognitive, emotional, social processes and behavior by observing, interpreting, and recording how people relate to one another and to their environments. Psychologists gather information and evaluate behavior through controlled laboratory experiments, psychoanalysis, psychotherapy or through personality, performance, aptitude, or intelligence tests, and use this information when testing theories in their research or when treating patients.
The provider doesn't accept Medicare and has signed an affidavit to be excluded from the Medicare program. If you are a Medicare beneficiary this means a provider can charge whatever they want for services rendered but must follow certain rules to do so. Jeffrey Bolek opted out of Medicare effective on 04-01-2017 until 04-01-2025. Opt out periods last for two years and cannot be terminated unless the provider is opting out for the very first time and the affidavit is terminated no later than 90 days after the opt out effective date. Opt-out affidavits might renew automatically renew every two years. The provider opted out of Medicare but is permitted to order and refer services to other healthcare providers.
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychologist
- Taxonomy Code
- 103T00000X
- Type
- Behavioral Health & Social Service Providers
- License No.
- 3496
- License State
- OH
- Taxonomy Description
- A psychologist is an individual who is licensed to practice psychology which is defined as the observation, description, evaluation, interpretation, and modification of human behavior by the application of psychological principles, methods, and procedures, for the purpose of preventing or eliminating symptomatic, maladaptive, or undesired behavior and of enhancing interpersonal relationships, work and life adjustment, personal effectiveness, behavioral health, and mental health. The practice of psychology includes, but is not limited to, psychological testing and the evaluation or assessment of personal characteristics, such as intelligence, personality, abilities, interests, aptitudes, and neuropsychological functioning; counseling, psychoanalysis, psychotherapy, hypnosis, biofeedback, and behavior analysis and therapy; diagnosis and treatment of mental and emotional disorder or disability, alcoholism and substance abuse, disorders of habit or conduct, as well as of the psychological aspects of physical illness, accident, injury, or disability; and psycheducational evaluation, therapy, remediation, and consultation. Psychological services may be rendered to individuals, families, groups and the public.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 103TR0400X | Behavioral Health & Social Service Providers | Psychologist | 3496 (OH) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 2057116 | MEDICAID (05) | OH | |
| BOCP79371 | MEDICARE PIN (08) | OH | |
| H135742 | MEDICARE PIN (08) | OH |
Medicare Participation & PECOS Enrollment Status
Jeffrey Bolek is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Opted-Out of Medicare? Yes
Opt-Out Effective Date: 04-01-2017
Opt-Out End Date: 04-01-2025
Eligible to Order and Refer? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): No
Eligible to Order or Refer Power Mobility Devices: No
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 1 | 3 | 4 | 2 | 1 | 7 | 5 | 3 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 1 | 6 | 4 | 4 | 1 | 14 | 5 | 6 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 1 + 6 + 4 + 4 + 1 + 1 + 4 + 5 + 6 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1134217532 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 14 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1891709788 | MS. SUSAN MARIE CYPHERS MSW Individual | Counselor (Addiction (Substance Use Disorder)) | 21403 CHAGRIN BLVD SUITE 210 BEACHWOOD, OH 44122 (216) 561-3211 |
| 1588740898 | MRS. BARBARA WOHLWORTH FIELDS LISW Individual | Social Worker (Clinical) | 21403 CHAGRIN BLVD SUITE 210 BEACHWOOD, OH 44122 (216) 752-0265 |
| 1790842862 | LANA KIRK GINNIS L.I.S.W. Individual | Social Worker (Clinical) | 21403 CHAGRIN BLVD SUITE 105 BEACHWOOD, OH 44122 (216) 991-2707 |
| 1295863736 | JAMES I KEPNER PHD Individual | Psychologist | 21403 CHAGRIN BLVD STE 210 BEACHWOOD, OH 44122 (216) 283-0736 |
| 1205053477 | MS. CAROL PAULL LISW Individual | Social Worker (Clinical) | 21403 CHAGRIN BLVD BEACHWOOD, OH 44122 (216) 991-2707 |
| 1659592681 | DR. MARK MCCONVILLE PH.D. Individual | Psychologist (Clinical) | 21403 CHAGRIN BLVD SUITE 210 BEACHWOOD, OH 44122 (216) 751-1007 |
| 1639342959 | MRS. HEIDI RUBIN ABRAMS Individual | Social Worker (Clinical) | 21403 CHAGRIN BLVD SUITE 210 BEACHWOOD, OH 44122 (216) 402-3739 |
| 1215178637 | DR. MARLENE MOSS BLUMENTHAL PH.D. Individual | Psychologist (School) | 21403 CHAGRIN BLVD #210 BEACHWOOD, OH 44122 (216) 751-1007 |
| 1679810774 | ADAM ROTH PHD Individual | Psychologist | 21403 CHAGRIN BLVD 210 BEACHWOOD, OH 44122 (216) 225-8376 |
| 1669711875 | ADAM H ROTH PHD LLC Organization | Psychologist (Clinical) | 21403 CHAGRIN BLVD #210 BEACHWOOD, OH 44122 (216) 225-8376 |
| 1295147494 | DAVID GRANOFF PSY.D. Individual | Psychologist (Clinical) | 21403 CHAGRIN BLVD SUITE 210 BEACHWOOD, OH 44122 (216) 752-5346 |
| 1518095751 | DAVID L. GRANOFF, PSY.D., INC. Organization | Psychologist | 21403 CHAGRIN BLVD SUITE 210 BEACHWOOD, OH 44122 (216) 752-5346 |
| 1366521890 | DR. MARY ANN KRAUS PSY.D. Individual | Psychologist | 21403 CHAGRIN BLVD SUITE 210 BEACHWOOD, OH 44122 (216) 406-8987 |
| 1275367278 | MR. JASON AARON DECKER LPC Individual | Counselor (Mental Health) | 21403 CHAGRIN BLVD BEACHWOOD, OH 44122 (216) 800-8524 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1134217532, enumerated in the NPI registry as an "individual" on October 11, 2006
The provider is located at 21403 Chagrin Blvd Beachwood, Oh 44122 and the phone number is (216) 346-5673
The provider's speciality is Psychologist with taxonomy code 103T00000X
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging and Durable Medical Equipment (DME).
No, the provider signed an affidavit on April 01, 2017 to opt-out of the Medicare program. The provider is excluded from the Medicare program until April 01, 2025.
This NPI record was last updated on October 11, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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