Simon Sarkis Boulattouf, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

MD456444 Issued in PA

Practice address

119 Shoemaker Rd
Pottstown, PA 19464-6429

Phone

(610) 427-4919

Fax

(802) 225-7103

NPI assigned

Jun 17, 2011

Last updated

Feb 15, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in VA, MD, DC, NJ, PA5 enrollments

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 5

Specialty

Family Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Patient First Maryland Medical Group PLLCGroup PAC ID 4385538735, 258 clinicians

Patient First Pennsylvania Medical Group PLLCGroup PAC ID 5193900280, 132 clinicians

Patient First Richmond Medical Group PLLCGroup PAC ID 9931011434, 315 clinicians

Patient First New Jersey Physicians Group LLCGroup PAC ID 6608220322, 42 clinicians

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Patient First Maryland Medical Group, PLLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1962423632

  MD

  Medicare reassignment Care Compare group NPD
• Patient First New Jersey Physicians Group LLC

  • Urgent Care Clinic/Center
  • Glen Allen, VA
  • NPI 1285317750

  Family Medicine, NJ

  Medicare reassignment Care Compare group NPD
• Patient First Pennsylvania Medical Group PLLC

  • Urgent Care Clinic/Center
  • Glen Allen, VA
  • NPI 1194039560

  Family Medicine, PA

  Medicare reassignment Care Compare group NPD
• Patient First Richmond Medical Group PLLC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1689603748

  DC

  Medicare reassignment Care Compare group NPD
• Patient First Maryland Medical Group PLLC

  • Family Medicine Physician
  • Silver Spring, MD
  • NPI 1265866503

  DC

  Medicare reassignment NPD
• Patient First Maryland Physician's Group PC

  • Family Medicine Physician
  • Glen Allen, VA
  • NPI 1982733564

  NJ

  Medicare reassignment NPD
• Patient First Pennsylvania Medical Group PLLC

  • Family Medicine Physician
  • Fairless Hills, PA
  • NPI 1144870387
  NPD
• Patient First Pennsylvania Medical Group PLLC

  • Family Medicine Physician
  • Montgomeryville, PA
  • NPI 1568712677
  NPD
• Patient First Maryland Medical Group PLLC

  • Family Medicine Physician
  • Capitol Heights, MD
  • NPI 1427807999
  NPD
• Patient First New Jersey Physicians Group LLC

  dba Patient First - Woodbury

  • Family Medicine Physician
  • Woodbury, NJ
  • NPI 1396528980
  NPD
• Patient First Richmond Medical Group PLLC

  • Urgent Care Clinic/Center
  • Fairfax, VA
  • NPI 1588018881

  Family Medicine

  NPD
• Patients First Maryland Physicians Group P C

  • Family Medicine Physician
  • Cherry Hill, NJ
  • NPI 1114477270
  NPD

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

{
    "created_epoch": "1308268800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613347200000",
    "number": "1821383761",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5000 COX RD",
            "city": "GLEN ALLEN",
            "state": "VA",
            "postal_code": "230609263",
            "telephone_number": "804-968-5700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "119 SHOEMAKER RD",
            "city": "POTTSTOWN",
            "state": "PA",
            "postal_code": "194646429",
            "telephone_number": "610-427-4919",
            "fax_number": "802-225-7103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULATTOUF",
        "first_name": "SIMON",
        "middle_name": "SARKIS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-17",
        "last_updated": "2021-02-15",
        "certification_date": "2021-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VT",
            "license": "042-0013623",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MD",
            "license": "D0073492",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NJ",
            "license": "25MA08958000",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "0101250048",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "PA",
            "license": "MD456444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Crystal Lynn Booth, M.S., L.P.C.
• Joseph Michael Borysowski, ATC
• Hilary Anne Boscoe
• Boscovs Department Store LLC (Boscov's Optical)
• Jennifer Bouher
• Jennifer Rose Bowen
• Bowman Prosthetics and Orthotics
• Tiffany Marie Bowman
• Brooke Boyd
• Rachel Boyd

• Family Medicine Physician in Pottstown, PA
• Providers in Pottstown, 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 Feb 15, 2021; 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.