Individual provider Active NPI

Kristine Serena Boulanger, M.D.

  • Anesthesiology Physician
  • Dallas, TX
National Provider Identifier
1710054291
Registry record updated Jul 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
P7252 Issued in TX
Practice address
12222 Merit Dr Ste 600
Dallas, TX 75251-3294
Phone
(972) 715-5000
Fax
(972) 715-9976
NPI assigned
Nov 29, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X BB5204071-KB63 MA
Anesthesiology Physician 207L00000X P7252 TX Primary

Addresses

Primary practice location

12222 Merit Dr Ste 600
Dallas, TX 75251-3294

Mailing address

PO Box 840853
Dallas, TX 75284-0853
Phone (972) 233-1999

Other practice location 1

600 S Tyler St Ste 2100
Amarillo, TX 79101-2304
Phone (972) 715-5000

Other identifiers 3

IdentifierTypeStateIssuer
8EY591OtherTXBCBS
326822902MedicaidTX
P01450152OtherTXRAILROAD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20131111001300 TX Practitioner - Anesthesiology 9537211354 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Baylor College of Medicine, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
U S Anesthesia Partners of Texas, PAGroup PAC ID 7315850351, 2,750 clinicians

Practice addresses (Care Compare)

1100 Allied Dr
Plano, TX 75093-5348
Phone (469) 814-3517

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
88.94 of 100Reported as group
Quality
91.31
Improvement activities
40
Cost
79.05

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
BB5204071-KB63MAMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
U S Anesthesia Partners of Texas, PA Anesthesiology CurrentSince Feb 18, 2015 Accepting new patients
U. S. Anesthesia Partners of Texas, P.a., Anesthesiology CurrentSince Feb 18, 2015 Accepting new patients

Locations

600 S Tyler St
Ste 2100
Amarillo, TX 79101
Phone (806) 810-6689

7777 Forest Ln
Dallas, TX 75230
Phone (972) 566-7283

3500 W Wheatland Rd
Dallas, TX 75237
Phone (214) 947-5950

12222 Merit Dr
Ste 600
Dallas, TX 75251
Phone (972) 361-1844

8200 Walnut Hill Ln
Dallas, TX 75231
Phone (214) 345-6148

1800 Park Place Ave
Ft Worth, TX 76110
Phone (682) 703-5600

900 8th Ave
Ft Worth, TX 76104
Phone (817) 336-2100

7600 Beechnut St
Houston, TX 77074
Phone (713) 456-5000

100 Medical Dr
Lake Jackson, TX 77566
Phone (713) 496-7555

1100 Allied Dr
Plano, TX 75093
Phone (469) 814-3278

9250 Pinecroft Dr
Shenandoah, TX 77380
Phone (281) 364-2300

Organizations & group practices 2

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1164758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658188800000",
    "number": "1710054291",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 840853",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752840853",
            "telephone_number": "972-233-1999",
            "fax_number": "972-233-3666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12222 MERIT DR STE 600",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752513294",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "600 S Tyler St Ste 2100",
            "address_purpose": "LOCATION",
            "city": "Amarillo",
            "state": "TX",
            "postal_code": "791012304",
            "country_code": "US",
            "telephone_number": "972-715-5000",
            "fax_number": "972-715-9976",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULANGER",
        "first_name": "KRISTINE",
        "middle_name": "SERENA",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-29",
        "last_updated": "2022-07-19",
        "certification_date": "2022-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "MA",
            "license": "BB5204071-KB63",
            "primary": false
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "P7252",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8EY591",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "326822902",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD",
            "identifier": "P01450152",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.