Stefanos Boukovalas, M.D.

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

62868 Issued in TN

Practice address

1934 Alcoa Hwy Ste D362
Knoxville, TN 37920-1524

Phone

(865) 305-4670

NPI assigned

Jul 28, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Plastic and Reconstructive Surgery

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

University Health System, Inc.Group PAC ID 5294646378, 512 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University Health System, Inc Hospital, Knoxville, TN, CCN 440015

Merit-based Incentive Payment System (MIPS)

Final score

96.48 of 100Reported as apm

Quality

86.23

Promoting interoperability

100

Improvement activities

40

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.

• University Health System, Inc

  • Internal Medicine Physician
  • Knoxville, TN
  • NPI 1790738763

  Multi-Specialty

  Medicare reassignment Care Compare group NPD
• University Health System Inc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Knoxville, TN
  • NPI 1306609748

  Multi-Specialty

  NPD
• University Health System, Inc

  • Plastic Surgery Physician
  • Knoxville, TN
  • NPI 1437460821

  Multi-Specialty

  NPD
• Knoxville Neurology Specialists, PLLC

  • Neurology Physician
  • Knoxville, TN
  • NPI 1720003338

  Multi-Specialty

  NPD (past)

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

• University Health System, Inc.

  • General Acute Care Hospital
  • Knoxville, TN
  • NPI 1538164090
  Care Compare affiliation

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

{
    "created_epoch": "1343433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649635200000",
    "number": "1235485137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415000-MSC8156",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372418156",
            "telephone_number": "865-670-6199",
            "fax_number": "865-670-6198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1934 ALCOA HWY STE D362",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379201524",
            "telephone_number": "865-305-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUKOVALAS",
        "first_name": "STEFANOS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-28",
        "last_updated": "2022-04-11",
        "certification_date": "2022-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "BP20066599",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TX",
            "license": "BP10052157",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "PA",
            "license": "MT202718",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "TN",
            "license": "62868",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jessica Botts, LPN
• Erin Bouchard
• Christina Bouchillon, PA
• Joseph Robert Boughter
• Bria Wall Boukovalas, CRNA
• Heydon Bouldin
• Reid Boulet, DDS, MSC
• Boulevard ENT Surgery Center LLC
• Kate Bounds, NP
• Matthew Wilson Bounds, MD

• Plastic Surgery Physician in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Plastic Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2022; 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.