Active NPI
Henda Bouali, MD
- Rheumatology Physician
- Vestal, NY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Rheumatology Physician
- License
- 246796
- Practice address
- 4417 Vestal Parkway East
Suite 202
Vestal, NY 13850-3556 - Phone
- (607) 770-7365
- Fax
- (607) 729-5882
- NPI assigned
- Oct 24, 2006
- Last updated
- Sep 19, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rheumatology Physician | 207RR0500X | 246796 | NY | Primary |
Addresses
Primary practice location
4417 Vestal Parkway East
Suite 202
Vestal, NY 13850-3556
Mailing address
346 Grand Ave
Johnson City, NY 13790-2580
Phone (607) 729-8156
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 02940054 | Medicaid | NY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Rheumatology
- Education
- Other, 1998
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
33 -57 Harrison St
Johnson City, NY 13790-2107
Phone (607) 763-6101
4417 Vestal Pkwy E
Vestal, NY 13850-3556
Phone (607) 770-7365
4433 Vestal Pkwy E
Vestal, NY 13850-3556
Phone (607) 771-2220
54 Main St
Candor, NY 13743-1619
Phone (607) 659-7272
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 96.41 of 100
- Quality
- 90.71
- Promoting interoperability
- 99
- Improvement activities
- 40
Merit-based Incentive Payment System (MIPS)
- Final score
- 89.14 of 100
- Quality
- 86.74
- Promoting interoperability
- 99
- Improvement activities
- 40
- Cost
- 70.09
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 246796 | NY | MD | Rheumatology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Delaware Valley Hospital, Inc | Current | Accepting new patients | |
| Delaware Valley Hospital, Inc | Current | Accepting new patients | |
| United Health Services Hospitals, Inc. | Current | Accepting new patients |
Locations
33 Lewis Rd
Fl 2
Binghamton, NY 13905
Phone (607) 729-8156
33-57 Harrison St
Johnson City, NY 13790
Phone (607) 763-6412
346 Grand Ave
Johnson City, NY 13790
Phone (607) 729-8156
4417 Vestal Pkwy E
Ste 202
Vestal, NY 13850
Phone (607) 770-7365
4433 Vestal Pkwy E
Vestal, NY 13850
Phone (607) 762-2176
2 Titus Pl
Walton, NY 13856
Phone (607) 865-2197
2 Titus Pl
#13202
Walton, NY 13856
Phone (607) 865-2197
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Multi-Specialty Clinic/Center
- Johnson City, NY
- NPI 1962463851
-
- Critical Access Hospital Clinic/Center
- Walton, NY
- NPI 1144312646
-
- Critical Access Hospital
- Walton, NY
- NPI 1417940719
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Norwich, NY
- NPI 1770593956
-
- Critical Access Hospital
- Walton, NY
- NPI 1417940719
-
- General Acute Care Hospital
- Binghamton, NY
- NPI 1518998699
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1161648000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348012800000",
"number": "1053495465",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "346 GRAND AVE",
"city": "JOHNSON CITY",
"state": "NY",
"postal_code": "137902580",
"telephone_number": "607-729-8156",
"fax_number": "607-729-3982"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4417 VESTAL PARKWAY EAST",
"address_2": "SUITE 202",
"city": "VESTAL",
"state": "NY",
"postal_code": "138503556",
"telephone_number": "607-770-7365",
"fax_number": "607-729-5882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUALI",
"first_name": "HENDA",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-24",
"last_updated": "2012-09-19",
"status": "A"
},
"taxonomies": [
{
"code": "207RR0500X",
"taxonomy_group": "",
"desc": "Internal Medicine, Rheumatology",
"state": "NY",
"license": "246796",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "02940054",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Vestal, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2012; 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.