Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alexis Rae Bolton

Individual provider Family Nurse Practitioner · NPI 1215546197

Alexis Rae Bolton is a Nurse Practitioner in Downey, California. Qualified in 2019, 7 years ago. Practices with Luke Macyszyn MD Inc, a 2-clinician group and accepts Medicare assignment. Licensed in California.

Years since qualifying
7
Licensed in
CA
In the registry since
2020
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Practice location Address checks out

11500 Brookshire Ave
Downey, CA 90241-4917
Phone: (562) 904-5000
Fax: (562) 904-5140
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 95014147 (CA)

Record details

NPI number1215546197
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJuly 28, 2020
Last updated in NPPESMarch 29, 2022
Certification dateMarch 29, 2022

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Luke Macyszyn Md Inc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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