Individual provider Active NPI

Suzy T Boules, M.D

  • General Practice Physician
  • Orlando, FL
National Provider Identifier
1609042563
Registry record updated May 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
ME 92072 Issued in FL
Practice address
1701 N Mills Ave
Orlando, FL 32803-1851
Phone
(407) 204-7000
Fax
(407) 204-1366
NPI assigned
May 1, 2008
Last updated
May 7, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 7, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X ME 92072 FL Primary

Addresses

Primary practice location

1701 N Mills Ave
Orlando, FL 32803-1851

Mailing address

6255 W Sunset Blvd FL 21
Los Angeles, CA 90028-7422
Phone (323) 860-5200

Other identifiers 2

IdentifierTypeStateIssuer
ME92072OtherFLPROFESSIONAL LICENSE NUMBER
1609042563OtherFLNPI NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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

Enrollment IDStateProvider typePAC IDDetails
I20100128000858 FL Practitioner - General Practice 5294877254 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Other, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
AIDS Healthcare FoundationGroup PAC ID 2668369109, 101 clinicians

Practice addresses (Care Compare)

3135 State Rd
Suite 1
Safety Harbor, FL 34695-4917
Phone (727) 725-9931

707 E Colonial Dr
Orlando, FL 32803-4600
Phone (407) 204-7000

Merit-based Incentive Payment System (MIPS)

Final score
82.5 of 100Reported as group
Quality
64.78
Improvement activities
40
Cost
79.23

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME 92072FLMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Health Care Center for the Homeless Inc CurrentSince Mar 16, 2015 Accepting new patients
AIDS Healthcare Foundation Current Accepting new patients
AIDS Healthcare Foundation CurrentSince Mar 27, 2017 Accepting new patients
AIDS Healthcare Foundation CurrentSince Mar 27, 2017 Accepting new patients
Health Care Center for the Homeless, Inc. CurrentSince Mar 16, 2015 Accepting new patients

Locations

6255 W Sunset Blvd
Fl 21
Los Angeles, CA 90028
Phone (323) 860-5200

1701 N Mills Ave
Orlando, FL 32803
Phone (407) 204-7000

232 N Orange Blossom Trl
Orlando, FL 32805

707 E Colonial Dr
Orlando, FL 32803
Phone (407) 204-7000

3135 State Road 580
Ste 1
Safety Harbor, FL 34695
Phone (727) 259-2000

Interoperability endpoints

  • Direct secure messaging: suzy.boules.1@26356.direct.athenahealth.com

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1209600000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715040000000",
    "number": "1609042563",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6255 W SUNSET BLVD FL 21",
            "city": "LOS ANGELES",
            "state": "CA",
            "postal_code": "900287422",
            "telephone_number": "323-860-5200",
            "fax_number": "323-467-7119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1701 N MILLS AVE",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328031851",
            "telephone_number": "407-204-7000",
            "fax_number": "407-204-1366"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULES",
        "first_name": "SUZY",
        "middle_name": "T",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-05-01",
        "last_updated": "2024-05-07",
        "certification_date": "2024-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "FL",
            "license": "ME 92072",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE NUMBER",
            "identifier": "ME92072",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI NUMBER",
            "identifier": "1609042563",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Orlando, FL

Sources for this page

Verify at the official NPI Registry.