Individual provider Active NPI

Andrew J. Bouley, M.D.

  • Neurology Physician
  • Wellesley, MA
National Provider Identifier
1831539519
Registry record updated May 26, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurology PhysicianTaxonomy code 2084N0400X
License
270183 Issued in MA
Practice address
110 Cedar St Ste 110
Wellesley, MA 02481-3527
Phone
(781) 591-8300
NPI assigned
Jun 26, 2013
Last updated
May 26, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 26, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurology Physician 2084N0400X 270183 MA Primary

Addresses

Primary practice location

110 Cedar St Ste 110
Wellesley, MA 02481-3527

Mailing address

110 Cedar St Ste 110
Wellesley, MA 02481-3527
Phone (781) 591-8300

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20170915001428 MA Practitioner - Neurology 8628295359 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Neurology
Education
Duke University School of Medicine, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Elliot Lewis Center for Multiple Sclerosis Care LLCGroup PAC ID 3072807650, 2 clinicians

Practice addresses (Care Compare)

110 Cedar St
Suite 110
Wellesley, MA 02481-3527
Phone (781) 591-8300

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
270183MAMDNeurology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mt Auburn Professional Services Neurology CurrentSince Jan 1, 2018 Accepting new patients
The Elliot Lewis Center for Multiple Sclerosis Care LLC Neurology CurrentSince Jul 24, 2022 Accepting new patients
The Elliot Lewis Center for Multiple Sclerosis Care LLC Neurology CurrentSince Dec 17, 2020 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Jul 23, 2018 Accepting new patients
Umass Memorial Medical Group, Inc. CurrentSince Jul 23, 2018 Accepting new patients
Mount Auburn Professional Services Inc Neurology CurrentSince Jan 1, 2018 Accepting new patients

Locations

300 Mount Auburn St
Ste 316
Cambridge, MA 02138
Phone (617) 868-0880

57 Bedford St
Ste 130
Lexington, MA 02420
Phone (781) 484-7500

110 Cedar St
Ste 110
Wellesley Hills, MA 02481
Phone (781) 591-8300

119 Belmont St
Worcester, MA 01605
Phone (508) 334-6345

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/86/brand/1/csg/1/fhir/r4

Organizations & group practices 6

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1372204800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1590451200000",
    "number": "1831539519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "110 CEDAR ST STE 110",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024813527",
            "telephone_number": "781-591-8300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 CEDAR ST STE 110",
            "city": "WELLESLEY",
            "state": "MA",
            "postal_code": "024813527",
            "telephone_number": "781-591-8300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULEY",
        "first_name": "ANDREW",
        "middle_name": "J.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-26",
        "last_updated": "2020-05-26",
        "certification_date": "2020-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "MA",
            "license": "270183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wellesley, MA

Sources for this page

Verify at the official NPI Registry.