Magdy I. Boulos, MD

Primary specialty

Neurological Surgery PhysicianTaxonomy code 207T00000X

License

C10001618 Issued in DE

Practice address

774 Christiana Road
Suite 202 Delaware Neurosurgical Group, PA
Newark, DE 19713

Phone

(302) 366-7671

Fax

(302) 366-7549

NPI assigned

Sep 21, 2006

Sex

Male

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

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.140.72127

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.

• Delaware Neurosurgical Group, P.a.

  • Specialist
  • Newark, DE
  • NPI 1770676629
  NPD
• Neurosurgery Associates, P.a.

  • Neurological Surgery Physician
  • Wilmington, DE
  • NPI 1447358338
  NPD (past)

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

{
    "created_epoch": "1158796800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277078400000",
    "number": "1164520037",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "774 CHRISTIANA ROAD",
            "address_2": "SUITE 202 DELAWARE NEUROSURGICAL GROUP, PA",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-366-7671",
            "fax_number": "302-366-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "774 CHRISTIANA ROAD",
            "address_2": "SUITE 202 DELAWARE NEUROSURGICAL GROUP, PA",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "19713",
            "telephone_number": "302-366-7671",
            "fax_number": "302-366-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "MAGDY",
        "middle_name": "I.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-21",
        "last_updated": "2010-06-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "DE",
            "license": "C10001618",
            "primary": true
        },
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "MD",
            "license": "D0020406",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "441142071",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Noelle M Bothe, NP
• Lynne Bouffard, NP
• Kristen Michelle Bougher, MD
• Annie-Kamerleen Bouhairie, M.D.
• Kimberly Ann Boulden, MSW
• Paul T Boulos, MD
• Elaine Boustila
• Justin Bowen
• Christopher A Bowens, M.D.
• Ariana Bowers, SPEECH LANGUAGE PATH

• Neurological Surgery Physician in Newark, DE
• Providers in Newark, DE by specialty
• Neurological Surgery Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.