Taylor Boulos, APN

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

26NJ00803300 Issued in NJ

Practice address

17 Alden Ter
Little Silver, NJ 07739-1001

Phone

(732) 533-3593

NPI assigned

Aug 7, 2018

Last updated

Aug 5, 2022By the provider in NPPES

Sex

Female

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 NJ

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sports and Spine Healthcare LLCGroup PAC ID 5698183630, 4 clinicians

Advanced WellnessGroup PAC ID 2163436148, 18 clinicians

Shaan Chiro LLCGroup PAC ID 9739544313, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Advanced Wellness

  • Chiropractor
  • Marlboro, NJ
  • NPI 1326053273
  Medicare reassignment Care Compare group NPD
• Shaan Chiro LLC

  dba Carteret Spine & Sports Rehab

  • Sports Physician Chiropractor
  • Carteret, NJ
  • NPI 1871291773
  Medicare reassignment Care Compare group NPD
• Sports and Spine Healthcare LLC

  dba Evergreen Healthcare Associates

  • Neurology Chiropractor
  • Vineland, NJ
  • NPI 1013593748
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1533600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1356820823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 ALDEN TER",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 ALDEN TER",
            "city": "LITTLE SILVER",
            "state": "NJ",
            "postal_code": "077391001",
            "telephone_number": "732-533-3593"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "25 Branch Ave",
            "address_purpose": "LOCATION",
            "city": "Red Bank",
            "state": "NJ",
            "postal_code": "077012201",
            "country_code": "US",
            "telephone_number": "732-533-3593",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "TAYLOR",
        "credential": "APN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-07",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "NJ",
            "license": "26NJ00803300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Iza M Boesler, MD
• Katherine Ann Bohnert, D.O.
• Therese Bonanni
• Elizabeth K Bond, PH.D.
• Renata Borges Dos Santos, PI
• Patricia Colleen Boylan, DPM
• Brie Donzella, LPC
• Ross Brown
• Allison Buleza, BCBA
• Nancy Sell Byron, MSW

• Nurse Practitioner in Little Silver, NJ
• Providers in Little Silver, NJ by specialty
• Nurse Practitioner in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 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.