Susan K Boolbol, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

2101701 Issued in NY

Practice address

45 Reade PL
Poughkeepsie, NY 12601-3947

Phone

(845) 214-1837

NPI assigned

Dec 6, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

General SurgeryAlso: Surgical Oncology

Education

George Washington University School of Medicine, 1994

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Nuvance Health Medical Practice PCGroup PAC ID 1658468442, 578 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Vassar Brothers Medical Center Hospital, Poughkeepsie, NY, CCN 330023

Merit-based Incentive Payment System (MIPS)

Final score

81.38 of 100Reported as group

Quality

63.01

Promoting interoperability

98

Improvement activities

40

Cost

72.3

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Nuvance Health Medical Practice PC

  • Internal Medicine Physician
  • Poughkeepsie, NY
  • NPI 1437358033
  Medicare reassignment Care Compare group NPD
• Icahn School of Medicine at Mount Sinai

  dba Surgery Department of Mount Sinai BI

  • Surgery Physician
  • New York, NY
  • NPI 1104295716
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba Surgery Department of Mount Sinai School of Medicine

  • Surgery Physician
  • New York, NY
  • NPI 1770823551
  Medicare reassignment NPD
• Icahn School of Medicine at Mount Sinai

  dba Beth Israel Medical Group of Mount Sinai

  • Internal Medicine Physician
  • New York, NY
  • NPI 1568868834
  NPD
• Icahn School of Medicine at Mount Sinai

  dba New York Eye & Ear Optical Shop

  • Eyewear Supplier
  • New York, NY
  • NPI 1760227466
  NPD
• Health Quest Medical Practice, PC

  • Diagnostic Radiology Physician
  • Kingston, NY
  • NPI 1558906610
  NPD (past)
• Hudson Valley Cardiovascular Practice, PC

  • Cardiovascular Disease Physician
  • Poughkeepsie, NY
  • NPI 1922435882
  NPD (past)

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

• Vassar Brothers Hospital

  • General Acute Care Hospital
  • Poughkeepsie, NY
  • NPI 1740233899
  Care Compare affiliation
• Vassar Brothers Medical Center

  dba Vassar Diagnostics

  • Clinical Medical Laboratory
  • Poughkeepsie, NY
  • NPI 1780052514

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1133827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638748800000",
    "number": "1154305720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21 READE PL STE 2100",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013968",
            "telephone_number": "845-214-1837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 READE PL",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126013947",
            "telephone_number": "845-214-1837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOOLBOL",
        "first_name": "SUSAN",
        "middle_name": "K",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-12-06",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "CT",
            "license": "67054",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "NY",
            "license": "2101701",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02169877",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• William E Bollengier, MD
• Brian John Bolz, LPN
• Emily Bonitatibus, FNP
• Heather Bonjolo
• Victoria Bonner, LPN
• Juliet Naidene Boone, M.S. SPEC.ED, MSIT
• Kissie Boone, LPN
• Meredith B. Booth, LMSW
• Abegail Bopela, LPN
• Richard A. Bordowitz, M.D.

• Surgery Physician in Poughkeepsie, NY
• Providers in Poughkeepsie, NY by specialty
• Surgery Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2021; 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.