Anthony A Bouldin, MD

Primary specialty

Neurology with Special Qualifications in Child Neurology PhysicianTaxonomy code 2084N0402X

License

MD00042649 Issued in WA

Practice address

600 Broadway Ste 400
Seattle, WA 98122-5312

Phone

(206) 215-1440

Fax

(206) 215-1441

NPI assigned

Oct 17, 2006

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 2

Medicare fee-for-service enrollment

Enrolled in WA, OR2 enrollments

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 2

Specialty

Neurology

Education

University of Louisville School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Swedish Health ServicesGroup PAC ID 0244138196, 1,038 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Swedish Medical Center / Cherry Hill Hospital, Seattle, WA, CCN 500025
• Swedish Issaquah Hospital, Issaquah, WA, CCN 500152

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abouldin1041216@oc.providencedirect.org

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.

• Swedish Health Services

  • Internal Medicine Physician
  • Seattle, WA
  • NPI 1689612954

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Providence Health & Services - Oregon

  • General Acute Care Hospital
  • Portland, OR
  • NPI 1114015971
  Medicare reassignment NPD
• Providence Health & Services Oregon

  • General Practice Physician
  • Lake Oswego, OR
  • NPI 1023488343
  Medicare reassignment NPD
• Providence Health & Services - Oregon

  • Neurology Physician
  • Portland, OR
  • NPI 1699804336
  NPD
• Providence Health & Services - Oregon

  • Clinical Pathology Physician
  • Portland, OR
  • NPI 1831641745
  NPD
• Providence Health & Services Oregon

  • Psychiatry Physician
  • Portland, OR
  • NPI 1760177737

  Child & Adolescent Psychiatry

  NPD
• Swedish Health Services

  • Surgery Physician
  • Seattle, WA
  • NPI 1053368571
  NPD (past)

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

• Swedish Health Services

  • General Acute Care Hospital
  • Seattle, WA
  • NPI 1356496582
  Care Compare affiliation
• Swedish Health Services

  • General Acute Care Hospital
  • Issaquah, WA
  • NPI 1851686059
  Care Compare affiliation

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1164503413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 25608",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841250608",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 BROADWAY STE 400",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225312",
            "telephone_number": "206-215-1440",
            "fax_number": "206-215-1441"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4800 Sand Point Way NE",
            "address_purpose": "LOCATION",
            "city": "Seattle",
            "state": "WA",
            "postal_code": "981053901",
            "country_code": "US",
            "telephone_number": "206-987-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULDIN",
        "first_name": "ANTHONY",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "WA",
            "license": "MD00042649",
            "primary": false
        },
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD00042649",
            "primary": false
        },
        {
            "code": "2084N0402X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology with Special Qualifications in Child Neurology",
            "state": "WA",
            "license": "MD00042649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8369795",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "INTERNAL ID-MOTOR VEHICLE ID",
            "identifier": "262640",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eli Boudouris, RN
• Alan Curtis Boudousquie, MD
• Hannah Louise Dahlem Boudreaux, PA-C
• Marie Kowalski Boudreaux
• Autum Rose Boulais
• Amanda E Boulis, PA
• Sara Boulos, RPH
• Caitlin Elise Boulware, MSOT
• Gusty-Lee Boulware, PHD-BCBA-D
• Bouma Orthosport, LLC

• Neurology with Special Qualifications in Child Neurology Physician in Seattle, WA
• Providers in Seattle, WA by specialty
• Neurology with Special Qualifications in Child Neurology Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.