Sara Nicole Stulac, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

248883 Issued in MA

Practice address

850 Harrison Avenue
Yawkey 4
Boston, MA 02118

Phone

(617) 414-4363

NPI assigned

Jul 16, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sstulac99781@direct.bmc.masshiway.net

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.

• Codman Square Health Center Inc

  • Community Health Clinic/Center
  • Dorchester Center, MA
  • NPI 1396808309
  Medicare reassignment NPD

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

{
    "created_epoch": "1279238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1407169717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "888 COMMONWEALTH AVE",
            "address_2": "3RD FLOOR",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022151205",
            "telephone_number": "617-998-8922",
            "fax_number": "617-432-5300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 HARRISON AVENUE",
            "address_2": "YAWKEY 4",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "02118",
            "telephone_number": "617-414-4363"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Longwood Ave",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021155724",
            "country_code": "US",
            "telephone_number": "617-355-6000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STULAC",
        "first_name": "SARA",
        "middle_name": "NICOLE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-07-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "NH",
            "license": "12857",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "248883",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110119302A",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Studley
• Courtney Studwell, MS, LCGC
• Steven Marshall Stufflebeam, MD
• Meredith Doyle Stuhlman, NP
• Elena M Stukalin, PA
• Adrienne Stulck, RDN, CNSC
• William Parker Stults, MD
• Collin M. Stultz, M.D.
• Benjamin F Stump, MD
• Dorian Lee Stump

• Pediatrics Physician in Boston, MA
• Providers in Boston, MA by specialty
• Pediatrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.