NPIMap

Individual provider Active NPI

Scott C Boulanger, MD

  • Pediatric Surgery Physician
  • Akron, OH
National Provider Identifier
1780616615
Registry record updated Apr 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Surgery PhysicianTaxonomy code 2086S0120X
License
35.087801 Issued in OH
Practice address
1 Perkins SQ
Akron, OH 44308-1063
Phone
(330) 543-6060
Fax
(330) 543-6069
NPI assigned
Jul 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 21, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Surgery Physician 2086S0120X 35.087801 OH Primary

Addresses

Primary practice location

1 Perkins SQ
Akron, OH 44308-1063

Mailing address

1 Perkins SQ
Akron, OH 44308-1063
Phone (330) 543-6060

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address sboulanger45551@direct.chmca.org
Direct Messaging Address sboulanger45551@direct.chmca.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060724000069 OH Practitioner - General SurgeryPractitioner - Pediatric Medicine 2163316860 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35.087801OHMDPediatric Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Metrohealth System CurrentSince Oct 7, 2015 Accepting new patients
Children'S Hospital Medical Center of Akron CurrentSince Apr 1, 2016 Accepting new patients
University Hospitals Medical Group Inc CurrentSince Jan 1, 2007 Accepting new patients
The Metrohealth System CurrentSince Oct 7, 2015 Accepting new patients
Children'S Hospital Medical Center of Akron CurrentSince Apr 1, 2016 Accepting new patients
Akron Children'S Hospital Current Accepting new patients
Children'S Hospital Medical Center of Akron Current Accepting new patients
University Surgery Associates, PLLC Pediatric Surgery Past Accepting new patients
Children'S Hospital Medical Center of Akron Past Accepting new patients

Locations

1 Perkins Sq
Akron, OH 44308
Phone (330) 543-8050

2500 Metrohealth Dr
Cleveland, OH 44109
Phone (216) 778-2348

11100 Euclid Ave
Cleveland Heights, OH 44106

1045 W High Ave
New Philadelphia, OH 44663
Phone (330) 308-5432

Interoperability endpoints

  • Direct secure messaging: sboulanger@direct.swgeneral.com

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1152230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618963200000",
    "number": "1780616615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-6060",
            "fax_number": "330-543-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 PERKINS SQ",
            "city": "AKRON",
            "state": "OH",
            "postal_code": "443081063",
            "telephone_number": "330-543-6060",
            "fax_number": "330-543-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULANGER",
        "first_name": "SCOTT",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-07",
        "last_updated": "2021-04-21",
        "certification_date": "2021-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2086S0120X",
            "taxonomy_group": "",
            "desc": "Surgery, Pediatric Surgery",
            "state": "OH",
            "license": "35.087801",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sboulanger45551@direct.chmca.org",
            "affiliation": "N",
            "address_1": "215 W Bowery St",
            "city": "Akron",
            "state": "OH",
            "country_code": "US",
            "postal_code": "443081069",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "sboulanger45551@direct.chmca.org",
            "affiliation": "N",
            "address_1": "1045 W High Ave",
            "city": "New Philadelphia",
            "state": "OH",
            "country_code": "US",
            "postal_code": "446632071",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Akron, OH

Sources for this page

Verify at the official NPI Registry.