Edmund C.a. Boulting, M.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

ME70127 Issued in FL

Practice address

785 Primera Blvd
Suite 1031
Lake Mary, FL 32746-2124

Phone

(407) 834-8111

Fax

(407) 708-1958

NPI assigned

Feb 22, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Obstetrics/Gynecology

Education

University of Miami, LM Miller School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ability Health Services, IncGroup PAC ID 4082523329, 1,249 clinicians

Ability Health Services and Rehabilitation LPGroup PAC ID 4981986288, shared by 2 NPIs, 1,260 clinicians

Florida Woman Care LLCGroup PAC ID 5395807218, 607 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Adventhealth Orlando Hospital, Orlando, FL, CCN 100007

Merit-based Incentive Payment System (MIPS)

Final score

88.76 of 100Reported as group

Quality

84.84

Promoting interoperability

100

Improvement activities

40

Cost

77.7

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• Freedom Health HMO Network
• Optimum HealthCare HMO Network

Interoperability endpoints

• Direct secure messaging: edmund.boulting.1@2183.direct.athenahealth.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.

• Florida Woman Care, LLC

  • Obstetrics & Gynecology Physician
  • Tampa, FL
  • NPI 1386823243
  Medicare reassignment Care Compare group NPD
• Womencare PA

  • Specialist
  • Orlando, FL
  • NPI 1366529042
  NPD (past)

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

• Adventist Health System-Sunbelt, Inc

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1306938071
  Care Compare affiliation
• Adventist Health System-Sunbelt, Inc

  • Clinical Medical Laboratory
  • Orlando, FL
  • NPI 1801569728

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1172102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1719273600000",
    "number": "1174658116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "785 PRIMERA BLVD",
            "address_2": "SUITE 1031",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462124",
            "telephone_number": "407-834-8111",
            "fax_number": "407-708-1958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "785 PRIMERA BLVD",
            "address_2": "SUITE 1031",
            "city": "LAKE MARY",
            "state": "FL",
            "postal_code": "327462124",
            "telephone_number": "407-834-8111",
            "fax_number": "407-708-1958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULTING",
        "first_name": "EDMUND",
        "middle_name": "C.A.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-22",
        "last_updated": "2024-06-25",
        "certification_date": "2024-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "FL",
            "license": "ME70127",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "379728700",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Samantha Bostelman
• Julie Bouchie
• Loryn Boudoin
• Kimberly Bougoulias, M.D.
• Michael Bougoulias, M.D.
• Molly Bowden, DPT
• Kaylee Marie Bower
• Erynne L Bowers, MD
• Blair Morgan Boyd
• Regina Boyd, M.A., LMHC

• Gynecology Physician in Lake Mary, FL
• Providers in Lake Mary, FL by specialty
• Gynecology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 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.