Paul Christopher Boulware, M.D.

Primary specialty

Psychiatry PhysicianTaxonomy code 2084P0800X

License

41726 Issued in AZ

Practice address

16620 N 40TH St Ste E-1
Phoenix, AZ 85032-3348

Phone

(602) 464-9576

Fax

(602) 626-8901

NPI assigned

Jan 30, 2007

Last updated

May 16, 2024By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

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

Psychiatry

Education

University of Missouri, Kansas City, School of Medicine, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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.

• Family Care Center, LLC

  • Psychiatry Physician
  • Mesa, AZ
  • NPI 1598535288
  Medicare reassignment Care Compare group NPD
• Amanda Anderson, MMS, PA-C, PLLC

  dba Pinnacle Psychiatry

  • Psychiatry Physician
  • Glendale, AZ
  • NPI 1073055414
  NPD (past)
• Arizona Neurological Institute, PC

  • Neurology Physician
  • Sun City, AZ
  • NPI 1669540662
  NPD (past)

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1609912146",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16620 N 40TH ST STE E1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323357",
            "telephone_number": "602-464-9576",
            "fax_number": "480-428-0475"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16620 N 40TH ST STE E-1",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850323348",
            "telephone_number": "602-464-9576",
            "fax_number": "602-626-8901"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULWARE",
        "first_name": "PAUL",
        "middle_name": "CHRISTOPHER",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-30",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AZ",
            "license": "41726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "435556",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Crystal Bouey, CRNA
• Bougainvillea Manor LLC (Bougainvillea Manor 2344)
• Michael Bougoulias, MD
• Boukus Inc (Arcadia Health and Wellness Chiropractic)
• Frederick Thornton Boulware, M.D.
• Paige E Bouma
• Boundless Light, PLLC
• Anne Bourgeois, NPC
• Megan Bourgeois, BSN RN
• Caroline Bourland

• Psychiatry Physician in Phoenix, AZ
• Providers in Phoenix, AZ by specialty
• Psychiatry Physician in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2024; 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.