Kyrollos Boules, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5501303435 Issued in MI

Practice address

940 River Centre Dr
Port Huron, MI 48060-4463

Phone

(810) 985-4900

Fax

(810) 985-3634

NPI assigned

Jan 20, 2022

Last updated

Dec 3, 2025By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in MI

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Rutgers New Jersey Medical School, 2015

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Orthopedic Associates of Port Huron PCGroup PAC ID 1951391093, 22 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/AIIFDD

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.

• Orthopedic Associates of Port Huron PC

  • Orthopaedic Surgery Physician
  • Port Huron, MI
  • NPI 1255341566
  Medicare reassignment Care Compare group NPD
• Orthopedic Associates of Port Huron PC

  • Durable Medical Equipment & Medical Supplies
  • Port Huron, MI
  • NPI 1013068188
  NPD (past)

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

{
    "created_epoch": "1642636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1265184303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 RIVER CENTRE DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604463",
            "telephone_number": "810-985-4900",
            "fax_number": "810-985-3634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 RIVER CENTRE DR",
            "city": "PORT HURON",
            "state": "MI",
            "postal_code": "480604463",
            "telephone_number": "810-985-4900",
            "fax_number": "810-985-3634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULES",
        "first_name": "KYROLLOS",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-20",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "5501303435",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittany Taylor Borges, PMHNP-DNP
• Richard Jay Bosscher, LMSW
• Todd D Boswell, CRNA
• Karen Boucher
• Rebecca Boughner
• Bailey A Bourassa, LLPC
• Anthony W Boutt, M.D.
• Jaime Boyachek
• Brian Patrick Boyd, DDS
• William McKenna Braaksma, M.D.

• Physical Therapist in Port Huron, MI
• Providers in Port Huron, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.