Individual provider Active NPI

Charles Bou, MD

  • Anesthesiology Physician
  • Middletown, NY
National Provider Identifier
1023091493
Registry record updated Aug 14, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
142072 Issued in NY
Practice address
707 E Main St
Middletown, NY 10940
Phone
(845) 333-1445
NPI assigned
Nov 21, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 142072 NY Primary

Addresses

Primary practice location

707 E Main St
Middletown, NY 10940

Mailing address

11781 Lee Jackson Memorial Hwy
Suite 550
Fairfax, VA 22033-3309
Phone (571) 777-5173

Other identifiers 3

IdentifierTypeStateIssuer
P01229245OtherNYRAILROAD MEDICARE
01543302MedicaidNY
00543302MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100604000502 NY Practitioner - Anesthesiology 5294746624

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
University of Puerto Rico School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North American Partners in Anesthesia LLPGroup PAC ID 7719885771, 427 clinicians

Practice addresses (Care Compare)

707 E Main St
Middletown, NY 10940-2650
Phone (845) 333-1000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
North American Partners in Anesthesia LLP Anesthesiology CurrentSince Jun 3, 2013 Accepting new patients
Maimonides Department of Psychiatry FPP Past Accepting new patients
Anesthesiology Associates of Boro Park, LLP Anesthesiology Past Accepting new patients
Orange Anesthesia Services P.C.. Anesthesiology Past Accepting new patients
Catskill Anesthesia Services Anesthesiology Past Accepting new patients
North American Partners in Anesthesia (Virginia), LLC Anesthesiology Past Accepting new patients

Locations

10201 66th Rd
Forest Hills, NY 11375
Phone (718) 830-4091

75 Crystal Run Rd
Ste 225
Middletown, NY 10941
Phone (845) 692-0800

111 Maltese Dr
Middletown, NY 10940

707 E Main St
Middletown, NY 10940
Phone (845) 333-1000

1510 Jericho Tpke
New Hyde Park, NY 11040
Phone (516) 216-5341

Organizations & group practices 6

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1132531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439510400000",
    "number": "1023091493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11781 LEE JACKSON MEMORIAL HWY",
            "address_2": "SUITE 550",
            "city": "FAIRFAX",
            "state": "VA",
            "postal_code": "220333309",
            "telephone_number": "571-777-5173",
            "fax_number": "703-766-9725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "707 E MAIN ST",
            "city": "MIDDLETOWN",
            "state": "NY",
            "postal_code": "10940",
            "telephone_number": "845-333-1445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOU",
        "first_name": "CHARLES",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-21",
        "last_updated": "2015-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NY",
            "license": "142072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01229245",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01543302",
            "state": "NY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00543302",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Middletown, NY

Sources for this page

Verify at the official NPI Registry.