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

Richard Gerald Bolanos Jr., MD

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1225358369

Richard Gerald Bolanos Jr., MD is an Obstetrics/Gynecology in Saint Louis, Missouri. Qualified in 2010, 16 years ago. Practices with Family Care Health Centers, a 52-clinician group and accepts Medicare assignment. Licensed in Missouri.

Years since qualifying
16
Licensed in
MO
In the registry since
2010
Specialties on file
2
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

4352 Manchester Ave
Saint Louis, MO 63110-2138
Phone: (314) 531-5444
Fax: (314) 531-0063
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Obstetrics & Gynecology Physician (primary) Taxonomy 207V00000X · Licence 2010020453 (MO)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1225358369
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJune 10, 2010
Last updated in NPPESJanuary 18, 2022
Certification dateJanuary 18, 2022

Medicare enrollment

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

Medicare specialtyOBSTETRICS/GYNECOLOGY
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Family Care Health Centers — 52 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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