MICHAEL BOULOS (NPI# 1083618581) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083618581 |
| Entity Type | Individual |
| Full Name | MICHAEL BOULOS |
| Credential | M.D. |
| Practice Address |
7250 Clearvista Dr Ste 120 Indianapolis IN 46256-4640 |
| Mailing Address |
6626 E 75th St Suite 500 Indianapolis IN 46250-2805 |
| Practice Telephone | 3176215676 |
| Practice Fax Number | 3176215678 |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2014-11-25 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RC0200X |
Internal Medicine Specialization: Critical Care Medicine |
01054000A | IN | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| IN | 200420800A | 05 | |
| IN | RR MEDICARE PTAN | P01214629 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558471730 | Michael Boulos | Physical Therapist | 350 West St. George Avenue, Linden, NJ 07036 | 2006-08-30 |
| 1326608365 | Michael Steven Boulos | Student in an Organized Health Care Education/Training Program | 10800 Knights Rd, Philadelphia, PA 19114-4200 | 2019-06-20 |
| Street Address |
7250 CLEARVISTA DR STE 120 |
| City | INDIANAPOLIS |
| State | IN |
| Zip Code | 46256-4640 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154325710 | Naraharisetty Aruna Rau | Psychiatry & Neurology | 7250 Clearvista Dr, Ste 225, Indianapolis, IN 46256-5626 | 2005-06-10 |
| 1912443623 | Shelby Wood | Physician Assistant | 7250 Clearvista Dr, Ste 355, Indianapolis, IN 46256-4692 | 2017-01-19 |
| 1700334935 | Nicole Hall | Physician Assistant | 7250 Clearvista Dr, Ste 355, Indianapolis, IN 46256-4692 | 2016-09-16 |
| 1134677800 | Ashley Peglow | Registered Nurse | 7250 Clearvista Dr, Ste 355, Indianapolis, IN 46256-4692 | 2016-09-12 |
| 1093260788 | Lauren Strem | Physician Assistant | 7250 Clearvista Dr, Ste 355, Indianapolis, IN 46256-4692 | 2016-08-23 |
| 1336692292 | Ana Peterson | Physician Assistant | 7250 Clearvista Dr, Ste 355, Indianapolis, IN 46256-0020 | 2016-07-27 |
| 1386197242 | Kimberly Neidigh | Physician Assistant | 7250 Clearvista Dr, Suite 355, Indianapolis, IN 46256-0020 | 2016-07-27 |
| 1154705887 | Heather Drouin | Nurse Practitioner | 7250 Clearvista Dr, Ste 355, Indianapolis, IN 46256-4692 | 2015-07-13 |
| 1285027060 | Lori Hufford | Pharmacist | 7250 Clearvista Dr, Suite 260, Indianapolis, IN 46256-4692 | 2015-03-18 |
| 1841639457 | Matthew J Becker | Physician Assistant | 7250 Clearvista Dr, Ste 355, Indianapolis, IN 46256-4692 | 2013-06-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790316859 | Jacob R Weeks | Behavior Technician | 9769 Crosspointed Blvd, Fishers, IN 46256 | 2020-01-28 |
| 1780236620 | Amare Hospice & Palliative Care | Family Medicine | 10475 Crosspoint Boulevard, Suite 250, Indianapolis, IN 46256 | 2019-07-11 |
| 1588226864 | Accutreat LLC | Clinical Medical Laboratory | 9661 Crosspoint Blvd, Indianapolis, IN 46256 | 2019-07-08 |
| 1447732557 | Kathleen O'hara | Marriage & Family Therapist | 8202 Clearvista Pkwy Unit 7, Indianapolis, IN 46256 | 2018-09-05 |
| 1205313608 | Healing Bridges Counseling, LLC | Marriage & Family Therapist | 8465 Keystone Crossing, Suite 266, Indianapolis, IN 46256 | 2018-07-27 |
| 1477062123 | Rosalee Ann Miller | Social Worker | 8202 Clearvista Parkway, Suite 6a, Indianapolis, IN 46256 | 2017-09-26 |
| 1760900039 | Amye Litherland | Registered Nurse | 7525 E. 82nd St Ste A, Indianapolis, IN 46256 | 2017-09-06 |
| 1275074239 | Jason Dempsey | Hearing Instrument Specialist | 8202 Clearvista Pkwy 3a, Indianapolis, IN 46256 | 2017-03-10 |
| 1578922761 | Fresenius Medical Care Indiana, LLC | Clinic/Center | 7155 Shadeland Station Way, Suite 130, Indianapolis, IN 46256 | 2016-02-16 |
| 1477925071 | Samantha Kitcoff | Physician Assistant | 8180 Clearvista Pkwy Ste 100, Indianapolis, IN 46256 | 2015-10-22 |
| Find all providers in zip 46256 | ||||
| Taxonomy Code | 207RC0200X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Critical Care Medicine |
| An internist who diagnoses, treats and supports patients with multiple organ dysfunction. This specialist may have administrative responsibilities for intensive care units and may also facilitate and coordinate patient care among the primary physician, the critical care staff and other specialists. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053744367 | Jagadeesh Yella | Internal Medicine | 1400 N Ritter Ave Ste 375, Indianapolis, IN 46219-3049 | 2013-08-11 |
| 1629356332 | Sangeeth Rao Dubbireddi | Internal Medicine | 1801 N Senate Ave Ste 2000, Indianapolis, IN 46202 | 2011-07-29 |
| 1265490445 | Caitriona Buckley | Internal Medicine | 550 University Blvd # Uh4903, Indianapolis, IN 46202-5149 | 2006-05-04 |
| 1861457715 | Omar Rahman | Internal Medicine | 1801 N. Capitol Ave., Np E-140, Indianapolis, IN 46202-1218 | 2006-04-20 |
| 1326040122 | Robert A Strawbridge | Internal Medicine | 8424 Naab Rd Ste 1h, Indianapolis, IN 46260-1954 | 2005-08-11 |
| 1366443400 | James D Pike | Internal Medicine | 7911 Michigan Rd, Indianapolis, IN 46268-1915 | 2005-08-10 |
| 1588666564 | Jon R Simala | Internal Medicine | 8330 Naab Rd Ste 340, Indianapolis, IN 46260-2279 | 2005-08-10 |
| 1801897236 | Lawrence J Bortenschlager | Internal Medicine | 1801 Senate Blvd, Suite 230, Indianapolis, IN 46202-1252 | 2005-08-09 |
| 1174527691 | Charles Brian Quick | Internal Medicine | 1400 N Ritter Ave, Suite 375b, Indianapolis, IN 46219-3052 | 2005-06-13 |
| 1225032725 | George Elias | Internal Medicine | 7120 Clearvista Dr, Ste 2100, Indianapolis, IN 46256-1621 | 2005-06-13 |
| Find all providers in INDIANAPOLIS | ||||
| City | INDIANAPOLIS |
| Zip Code | 46256 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.