Houman Bolourian, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

ME101168 Issued in FL

Practice address

8113 Centralia CT Ste 102
Leesburg, FL 34788-7521

Phone

(352) 663-9200

Fax

(352) 240-3941

NPI assigned

Mar 12, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in FL

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

Specialty

Family Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Adventist Health System Sunbelt, Inc. 212 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles (5 of 7)

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: hbolourian73170@adventhealth.direct-ci.com

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.

• Adventist Health System Sunbelt, Inc.

  • Urgent Care Clinic/Center
  • Maitland, FL
  • NPI 1073565610

  Family Medicine, FL

  Medicare reassignment Care Compare group NPD
• Urgent Care Centers of Brevard County LLC

  • Urgent Care Clinic/Center
  • Maitland, FL
  • NPI 1295367290

  Family Medicine, FL

  Medicare reassignment NPD
• Adventist Health System/ Sunbelt, Inc.

  • Urgent Care Clinic/Center
  • The Villages, FL
  • NPI 1396605440

  Family Medicine

  NPD
• Adventist Health System/Sunbelt, Inc.

  • Urgent Care Clinic/Center
  • Longwood, FL
  • NPI 1487841276

  Family Medicine

  NPD
• Urgent Care Centers of Brevard County LLC

  • Urgent Care Clinic/Center
  • Melbourne, FL
  • NPI 1801594858

  Family Medicine

  NPD

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

{
    "created_epoch": "1173657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725494400000",
    "number": "1124150396",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10850 EMERALD CHASE DR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328365882",
            "telephone_number": "407-721-2475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8113 CENTRALIA CT STE 102",
            "city": "LEESBURG",
            "state": "FL",
            "postal_code": "347887521",
            "telephone_number": "352-663-9200",
            "fax_number": "352-240-3941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8014 Conroy Windermere Rd Ste 104",
            "address_purpose": "LOCATION",
            "city": "Orlando",
            "state": "FL",
            "postal_code": "328352537",
            "country_code": "US",
            "telephone_number": "407-291-8975",
            "fax_number": "407-296-5220",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOLOURIAN",
        "first_name": "HOUMAN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-12",
        "last_updated": "2024-09-05",
        "certification_date": "2024-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WY",
            "license": "7717A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101243332",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME101168",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "7717A",
            "state": "WY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "101243332",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "101168",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bogdan Gogioiu MD PA
• Stephanie Bogeajis, OTR/L
• Stephen Bohusz, CRNA
• Rebecca Boler
• Janice Boleyn
• Kaylee Bolton
• Matthew Booker, APRN
• Brandi Boothe
• Rajesambhaji Shivajirao Borade, M.D.
• Sarah Bou Nader, M.D

• All providers in Leesburg, FL
• Family Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2024; 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.