Konstantinos D Boudoulas, M.D.

Primary specialty

Interventional Cardiology PhysicianTaxonomy code 207RI0011X

License

35.094280 Issued in OH

Practice address

452 W 10TH Ave
Columbus, OH 43210-1240

Phone

(614) 293-7677

Fax

(614) 293-5614

NPI assigned

Dec 12, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Interventional Cardiology

Education

Ohio State University College of Medicine, 2001

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Osu Internal Medicine LLCGroup PAC ID 5496651408, 1,141 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ohio State University State Health System Hospital, Columbus, OH, CCN 360085
• James Cancer Hospital & Solove Research Institute Hospital, Columbus, OH, CCN 360242

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kboudoulas9234@direct.osumc.edu

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Osu Internal Medicine, LLC

  • Internal Medicine Physician
  • Columbus, OH
  • NPI 1740231448

  Cardiovascular Disease

  Medicare reassignment Care Compare group NPD
• Lima Memorial Joint Operating Company

  • General Acute Care Hospital
  • Lima, OH
  • NPI 1336144732
  NPD (past)
• Ohio State University Hospitals

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1447359997
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Arthur G James Cancer Hospital and Research Institute

  • Special Hospital
  • Columbus, OH
  • NPI 1124127683
  Care Compare affiliation
• Ohio State University Hospitals

  • Rehabilitation Hospital Unit
  • Columbus, OH
  • NPI 1184723637
  Care Compare affiliation
• Ohio State University Hospitals

  • General Acute Care Hospital
  • Columbus, OH
  • NPI 1447359997
  Care Compare affiliation
• Ohio State University Hospitals

  • Psychiatric Hospital Unit
  • Columbus, OH
  • NPI 1790876183
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1003976507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "700 ACKERMAN RD STE 2120",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432021559",
            "telephone_number": "614-293-7677",
            "fax_number": "614-293-8518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "452 W 10TH AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432101240",
            "telephone_number": "614-293-7677",
            "fax_number": "614-293-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDOULAS",
        "first_name": "KONSTANTINOS",
        "middle_name": "D",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0011X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Interventional Cardiology",
            "state": "OH",
            "license": "35.094280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kboudoulas9234@direct.osumc.edu",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "3900 Stoneridge Ln Ste A",
            "city": "Dublin",
            "state": "OH",
            "country_code": "US",
            "postal_code": "430172289",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Erick Matthew Boucher, ATC
• Laura Carol Boucher, ATC
• Stacey Marie Boucher, FNP
• Stephanie Boucher, LPN
• Lauren Louise Boucherle, PA-C
• Michelle Leigh Boudoulas, CRNA
• Olga Boudoulas, MD
• John Boudouris, CNP
• Lauryn Boudreaux
• Daniel Boue, M.D.

• Interventional Cardiology Physician in Columbus, OH
• Providers in Columbus, OH by specialty
• Interventional Cardiology Physician in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.