Jaclyn Boulais, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

253867 Issued in MA

Practice address

800 Washington St
Boston, MA 02111-1552

Phone

(617) 636-5322

NPI assigned

Jun 17, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jaclyn.boulais@direct.signature.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.

• Physicians of Cape Cod Hospital

  • Neuroradiology Physician
  • Hyannis, MA
  • NPI 1679832364
  Medicare reassignment NPD
• Pratt Pediatric Associates Inc

  • Pediatrics Physician
  • Boston, MA
  • NPI 1477590511
  Medicare reassignment NPD
• Signature Healthcare Medical Group Inc

  dba Signature Medical

  • Internal Medicine Physician
  • Brockton, MA
  • NPI 1508804949

  Pediatrics

  Medicare reassignment NPD
• Brockton Hospital, Inc.

  dba Signature Healthcare Brockton Hospital

  • General Acute Care Hospital
  • Brockton, MA
  • NPI 1063431286
  NPD (past)
• Tufts Medical Center, Inc.

  dba Tufts Medical Center

  • General Acute Care Hospital
  • Boston, MA
  • NPI 1730132515
  NPD (past)

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

{
    "created_epoch": "1276732800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453248000000",
    "number": "1750602496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "171 SOUTH ST",
            "address_2": "UNIT 6A",
            "city": "JAMAICA PLAIN",
            "state": "MA",
            "postal_code": "021303958",
            "telephone_number": "413-281-3814"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 WASHINGTON ST",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021111552",
            "telephone_number": "617-636-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULAIS",
        "first_name": "JACLYN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-06-17",
        "last_updated": "2016-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MA",
            "license": "253867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Ananda Bougleux Gomes, MD
• Amina Bougrine, MD
• Sarah Bouhabel, MD
• Carel Bouharb
• Jason Tarek Bouhenguel
• Mary Catherine Boulanger, MD
• Jacinthe Boulet, MDCM
• Afroditi Boulougoura
• Lindsay Boulter, RN
• Georges Bounajem, M.D.

• 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 Jan 20, 2016; 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.