Valy Boulom, M.D.
Individual provider Active NPI Vascular Surgery Physician · Morgan Hill, CA
NPI 1174785232 · NPPES record last updated Nov 12, 2024
Key facts
- NPI
- 1174785232
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Vascular Surgery Physician 2086S0129X
- License
- 130020 (CA)
- Practice address
- 18525 Sutter Blvd Ste 140
Morgan Hill, CA 95037-2883 - Phone
- (408) 333-9580
- Fax
- (408) 663-5222
- NPI assigned
- Jun 30, 2008
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 18
Medicare Care Compare profile
- Specialty
- Vascular Surgery
- Education
- University of Southern California Keck School of Medicine, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Bass Medical Group
Practice addresses (Care Compare)
15899 Los Gatos Almaden Rd
Suite 12
Los Gatos, CA 95032-3739
Phone (408) 358-2663
18525 Sutter Blvd
Suite 140
Morgan Hill, CA 95037-2883
Phone (408) 333-9580
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 84 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160826001712 | CA | Practitioner - Vascular Surgery | 1951530419 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 130020 | CA | MD | Clinical Social Worker |
Practice roles (8 of 9)
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Shadelands Endovascular, LLC | Current |
Accepting new patients | |
| Bass Medical Group | Current |
Accepting new patients | |
| Bass Medical Group | Current |
Accepting new patients | |
| Bass Medical Group | Current | Accepting new patients | |
| California Pacific Medical Group, Inc. | Past | Accepting new patients | |
| Operation Blue Star | Past | Accepting new patients | |
| Bass Medical Group | Past | Accepting new patients | |
| Bass Medical Group | Past | Accepting new patients |
Locations
1505 Saint Alphonsus Way
Alamo, CA 94507
Phone (925) 837-4225
15055 Los Gatos Blvd
Ste 100
Los Gatos, CA 95032
Phone (408) 333-9580
15899 Los Gatos Almaden Rd
Ste 12
Los Gatos, CA 95032
Phone (408) 358-2663
18525 Sutter Blvd
Ste 140
Morgan Hill, CA 95037
Phone (408) 333-9580
16130 Juan Hernandez Dr
Ste 104
Morgan Hill, CA 95037
Phone (408) 333-9580
2204 Grant Rd
Ste 103
Mountain View, CA 94040
Phone (650) 967-8841
3190 S Bascom Ave
Ste 170
San Jose, CA 95124
Phone (408) 850-0176
460 N Wiget Ln
#B
Walnut Creek, CA 94598
Phone (925) 378-4500
365 Lennon Ln
Ste 250
Walnut Creek, CA 94598
Phone (925) 627-3424
2637 Shadelands Dr
Walnut Creek, CA 94598
Phone (925) 627-3424
Networks
- BSC 65 PLUS INDIVIDUAL MAPD
Interoperability endpoints
- vboulom115385@ehr.johnmuirhealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Vascular Surgery Physician | 2086S0129X | 130020 | CA | Yes |
Addresses
Primary practice location
18525 Sutter Blvd Ste 140
Morgan Hill, CA 95037-2883
Mailing address
18525 Sutter Blvd Ste 140
Morgan Hill, CA 95037-2883
Phone (408) 333-9580
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- Anthony Charles Boykins Sr.
- Maya Kierra Boykins
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All providers in Morgan Hill, CA · Vascular Surgery Physician in California
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 12, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.