Dany Boulos, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

036141752 Issued in IL

Practice address

11000 Roosevelt Blvd
360
Philadelphia, PA 19116-3961

Phone

(215) 677-1475

Fax

(215) 677-3082

NPI assigned

Aug 11, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Other identifiers 3

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in IL

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

Family Practice

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Cepamerica Illinois LLPGroup PAC ID 3274793633, 492 clinicians

Endeavor Health Medical GroupGroup PAC ID 2163334699, 3,330 clinicians

Advocate Health and Hospitals CorporationGroup PAC ID 7810800935, shared by 39 NPIs, 3,081 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Advocate Sherman Hospital Hospital, Elgin, IL, CCN 140030

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dboulos155632@direct.nch.org

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.

• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Elgin, IL
  • NPI 1912283110
  Medicare reassignment Care Compare group NPD
• Endeavor Health Medical Group

  dba NorthShore University HealthSystem Faculty Practice Associates

  • Emergency Medicine Physician
  • Evanston, IL
  • NPI 1497701882
  Medicare reassignment Care Compare group NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group (Dreyer)

  • Multi-Specialty Clinic/Center
  • Aurora, IL
  • NPI 1003542184
  Medicare reassignment NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Medical Group

  • Multi-Specialty Clinic/Center
  • Oak Brook, IL
  • NPI 1700824455
  Medicare reassignment NPD
• Northwest Community Health Services Inc

  dba NCH Medical Group

  • Internal Medicine Physician
  • Arlington Heights, IL
  • NPI 1134433154

  Family Medicine

  Medicare reassignment NPD
• Advocate Health & Hospitals Corp.

  dba Bethany Hospital

  • Emergency Medicine Physician
  • Chicago, IL
  • NPI 1750315545
  NPD
• Advocate Health and Hospitals Corporation

  dba Advocate Children's Hospital

  • Children's Hospital
  • Oak Lawn, IL
  • NPI 1508315516
  NPD
• Cep America - Illinois, LLP

  • Emergency Medicine Physician
  • Aurora, IL
  • NPI 1164975371
  NPD
• Cepamerica Illinois LLP

  • Emergency Medicine Physician
  • Springfield, IL
  • NPI 1871360297
  NPD
• Endeavor Health Medical Group

  dba NorthShore Anesthesia Group

  • Anesthesiology Physician
  • Evanston, IL
  • NPI 1265695944
  NPD
• Northwest Community Health Services Inc

  dba NCH Medical Group

  • Obstetrics Physician
  • Arlington Heights, IL
  • NPI 1467057513
  NPD

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

• Advocate Sherman Hospital

  • General Acute Care Hospital
  • Elgin, IL
  • NPI 1629026364
  Care Compare affiliation
• Sherman Hospital

  • Skilled Nursing Facility
  • Elgin, IL
  • NPI 1275584302

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1218412800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710892800000",
    "number": "1780830703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 820933",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191820933",
            "telephone_number": "215-926-9010",
            "fax_number": "215-226-8685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11000 ROOSEVELT BLVD",
            "address_2": "360",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191163961",
            "telephone_number": "215-677-1475",
            "fax_number": "215-677-3082"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "519 S Roselle Rd",
            "address_purpose": "LOCATION",
            "city": "Schaumburg",
            "state": "IL",
            "postal_code": "601932925",
            "country_code": "US",
            "telephone_number": "847-985-0600",
            "fax_number": "847-985-0600",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "486 Randall Rd Unit B",
            "address_purpose": "LOCATION",
            "city": "South Elgin",
            "state": "IL",
            "postal_code": "601773354",
            "country_code": "US",
            "telephone_number": "224-783-5000",
            "fax_number": "224-782-5018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "DANY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-11",
        "last_updated": "2024-03-20",
        "certification_date": "2024-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036141752",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD453720",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IN",
            "license": "01068800A",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "IL",
            "license": "036141752",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000718849",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201024290",
            "state": "IN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "036141752",
            "state": "IL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "dboulos287619@direct.myadvocateaurora.org",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "486 Randall Rd Unit B",
            "city": "South Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601773354",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://EpicFHIR.aurora.org/FHIR/MYAURORA/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "486 Randall Rd Unit B",
            "city": "South Elgin",
            "state": "IL",
            "country_code": "US",
            "postal_code": "601773354",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Paulia Bouges
• Adam James Bouhamdan
• Anastasia Bouikidis, CRNA
• Evangela Bouikidis, PA
• Mary Beth Boulden, LCSW, LPC
• Alexis Chen Boulter
• Brooklynn Ashley Boulware, PA-C
• Sabrina Bounader
• Bounce Back Chiropractic LLC
• Boundless Behavioral Solutions LLC

• Family Medicine Physician in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Family Medicine Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 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.