NPIMap

Individual provider Active NPI

Sarah E Boulos, D.O.

  • Emergency Medicine Physician
  • Pueblo, CO
National Provider Identifier
1245590165
Registry record updated Jul 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DR.0058402 Issued in CO
Practice address
400 W 16TH St
Pueblo, CO 81003-2745
Phone
(719) 584-4306
Fax
(719) 584-4861
NPI assigned
May 24, 2012
Last updated
Jul 30, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 20A13056 CA
Emergency Medicine Physician 207P00000X CA20A13056 CA
Emergency Medicine Physician 207P00000X DO3822 NV
Emergency Medicine Physician 207P00000X DR.0058402 CO Primary

Addresses

Primary practice location

400 W 16TH St
Pueblo, CO 81003-2745

Mailing address

4043 Las Casas Ave
Claremont, CA 91711-2324
Phone (909) 833-5355

Other practice location 1

400 N Pepper Ave
Colton, CA 92324-1801
Phone (909) 580-1000

Other practice location 2

1800 W Charleston Blvd
Las Vegas, NV 89102-2386
Phone (702) 383-2000

Other names 1

  • Sarah E Harms Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20170722000152 CO Practitioner - Emergency Medicine 5890094734 Reassigns benefits to 1 organization
I20250128002876 NV Practitioner - Emergency Medicine 5890094734 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1800 W Charleston Blvd
Las Vegas, NV 89102-2329
Phone (702) 383-2000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
77.65 of 100Reported as group
Quality
64.78
Improvement activities
40
Cost
70.76

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
20A13056CAMDEmergency Medicine Physician
CA20A13056CAMDEmergency Medicine Physician
DR.0058402COMDEmergency Medicine Physician
DO3822NVMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Center of Southern Nevada CurrentSince Mar 5, 2025 Accepting new patients
Southern Colorado Emergency Medical Associates Emergency Medicine CurrentSince Apr 1, 2025 Accepting new patients
Southern Colorado Emergency Medical Associates Emergency Medicine CurrentSince Apr 1, 2025 Accepting new patients
University Medical Center of Southern Nevada CurrentSince Mar 5, 2025 Accepting new patients

Locations

400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000

899 E Industrial Blvd
Pueblo West, CO 81007
Phone (719) 288-2100

1800 W Charleston Blvd
Las Vegas, NV 89102
Phone (702) 207-8253

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 12

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

NPI Registry JSON

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

{
    "created_epoch": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753833600000",
    "number": "1245590165",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4043 LAS CASAS AVE",
            "city": "CLAREMONT",
            "state": "CA",
            "postal_code": "917112324",
            "telephone_number": "909-833-5355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 W 16TH ST",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810032745",
            "telephone_number": "719-584-4306",
            "fax_number": "719-584-4861"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "400 N Pepper Ave",
            "address_purpose": "LOCATION",
            "city": "Colton",
            "state": "CA",
            "postal_code": "923241801",
            "country_code": "US",
            "telephone_number": "909-580-1000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1800 W Charleston Blvd",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891022386",
            "country_code": "US",
            "telephone_number": "702-383-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "SARAH",
        "middle_name": "E",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2025-07-30",
        "certification_date": "2025-07-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "20A13056",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "CA20A13056",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "NV",
            "license": "DO3822",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CO",
            "license": "DR.0058402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SARAH",
            "last_name": "HARMS",
            "middle_name": "E",
            "credential": "D.O.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Pueblo, CO

Sources for this page

Verify at the official NPI Registry.