Susannah Boulet, DO

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

DO01238 Issued in RI

Practice address

593 Eddy St.
Claverick 2
Providence, RI 02903

Phone

(401) 444-4000

NPI assigned

May 14, 2020

Last updated

Jun 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in PA

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

Merit-based Incentive Payment System (MIPS)

Final score

96.45 of 100Reported as group

Quality

85.46

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sboulet916202@direct.ahn.org

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.

• Ahn Emergency Group of Forbes LTD.

  • Emergency Medicine Physician
  • Monroeville, PA
  • NPI 1235554692
  Medicare reassignment NPD
• Ahn Emergency Group of Jefferson LTD

  • Emergency Medicine Physician
  • Jefferson Hills, PA
  • NPI 1235518499
  Medicare reassignment NPD
• Ahn Observation Group LLC

  • Emergency Medicine Physician
  • Jefferson Hills, PA
  • NPI 1437814696
  Medicare reassignment NPD

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

{
    "created_epoch": "1589414400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687219200000",
    "number": "1811519697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "125 WHIPPLE ST STE 3",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029083258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST.",
            "address_2": "CLAVERICK 2",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "02903",
            "telephone_number": "401-444-4000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "232 W 25th St",
            "address_purpose": "LOCATION",
            "city": "Erie",
            "state": "PA",
            "postal_code": "165440002",
            "country_code": "US",
            "telephone_number": "814-452-5000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULET",
        "first_name": "SUSANNAH",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-05-14",
        "last_updated": "2023-06-20",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "PA",
            "license": "OT020113",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "RI",
            "license": "DO01238",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine Bothe, LMHCA
• Haylie Botts, PA-C
• Jeremy M Boucher
• Robert Anthony Bouffard, PT
• Brianna Leigh Boulanger, MT
• Brittany Victoria Dalpe Bouley, LICSW
• Kimberly Diane Boullard, OTR
• Abigail Boulos, PA-C
• Erika Elizabeth Boulware, LCSW
• Cathy Bour, LICSW

• Emergency Medicine Physician in Providence, RI
• Providers in Providence, RI by specialty
• Emergency Medicine Physician in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2023; 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.