Athos Bousvaros, MD, MPH

Primary specialty

Pediatric Gastroenterology PhysicianTaxonomy code 2080P0206X

License

58765 Issued in MA

Practice address

300 Longwood Ave
Boston, MA 02115-5724

Phone

(617) 355-2962

NPI assigned

Aug 21, 2006

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

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

Specialty

Pediatric MedicineAlso: Gastroenterology

Education

Duke University School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Children'S Hospital Pediatric Associates, IncGroup PAC ID 3476541830, 333 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Boston Children'S Hospital Hospital, Boston, MA, CCN 223302

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: abousvaros21921@direct.bostonchildrens.org

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.

• Children'S Hospital Pediatric Associates, Inc

  • Pediatrics Physician
  • Boston, MA
  • NPI 1457306664

  Pediatric Gastroenterology

  Medicare reassignment Care Compare group NPD
• Children'S Hospital Corporation

  • Children's Hospital
  • Boston, MA
  • NPI 1710087127
  NPD (past)
• Childrens Hospital Boston

  • Children's Hospital
  • Boston, MA
  • NPI 1770741530
  NPD (past)

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

• Children'S Hospital Corporation

  • Children's Hospital
  • Boston, MA
  • NPI 1710087127
  Care Compare affiliation

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1528174885",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 FRANCES RD",
            "city": "LEXINGTON",
            "state": "MA",
            "postal_code": "024217512",
            "telephone_number": "781-623-3956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 LONGWOOD AVE",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021155724",
            "telephone_number": "617-355-2962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUSVAROS",
        "first_name": "ATHOS",
        "name_prefix": "Dr.",
        "credential": "MD, MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0206X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "MA",
            "license": "58765",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3074854",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bradley Allen Bousquet
• Hannah Grace Bousquet, MD
• Vassiliki A Boussiotis, MD PHD
• Ashley Boustany, MD
• Fred G. Boustany, DMD
• Michelle Boutet, RDN, CSSD, LD
• Tara C. Bouton, M.D.
• Rimoun Ramsis Anis Boutrus
• Kristan Marie Boutwell, RN, CPNP
• Clarice Bouvier, OD, MS

• Pediatric Gastroenterology Physician in Boston, MA
• Providers in Boston, MA by specialty
• Pediatric Gastroenterology Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.