Marwan Boulis, MD

Primary specialty

Otolaryngology PhysicianTaxonomy code 207Y00000X

License

4301509067 Issued in MI

Practice address

5220 Highland Rd Ste 230
Waterford, MI 48327-1973

Phone

(248) 254-8900

Fax

(248) 599-7191

NPI assigned

May 7, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

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

Otolaryngology

Education

Wayne State University School of Medicine, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

ENT Care of Michigan PLCGroup PAC ID 2466827753, 5 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Trinity Health Oakland Hospital Hospital, Pontiac, MI, CCN 230029
• Beaumont Hospital, Troy Hospital, Troy, MI, CCN 230269
• Beaumont Hospital Royal Oak Hospital, Royal Oak, MI, CCN 230130
• McLaren Oakland Hospital, Pontiac, MI, CCN 230207

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marwan.boulis.1@28822.direct.athenahealth.com
• Direct secure messaging: mboulis415819@direct.hfhs.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.

• ENT Care of Michigan PLC

  • Otolaryngology Physician
  • Waterford, MI
  • NPI 1114632932
  Medicare reassignment Care Compare group NPD
• ENT Care of Michigan PLC

  • Audiologist
  • Waterford, MI
  • NPI 1871282772
  NPD

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

• McLaren Oakland

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1376564088
  Care Compare affiliation
• St Joseph Mercy Hospital-SMHC

  • General Acute Care Hospital
  • Pontiac, MI
  • NPI 1053356352
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Troy, MI
  • NPI 1306825997
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Royal Oak, MI
  • NPI 1689653305
  Care Compare affiliation
• William Beaumont Hospital

  • General Acute Care Hospital
  • Grosse Pointe, MI
  • NPI 1932396017
  Care Compare affiliation

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

{
    "created_epoch": "1525651200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721260800000",
    "number": "1861981763",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5220 HIGHLAND RD STE 230",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271973",
            "telephone_number": "248-254-8900",
            "fax_number": "248-599-7191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5220 HIGHLAND RD STE 230",
            "city": "WATERFORD",
            "state": "MI",
            "postal_code": "483271973",
            "telephone_number": "248-254-8900",
            "fax_number": "248-599-7191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULIS",
        "first_name": "MARWAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-07",
        "last_updated": "2024-07-18",
        "certification_date": "2023-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "MI",
            "license": "4301509067",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Anthony Boniface, LLPC, NCC
• Bormans Inc
• Emily Bosnack, LMSW
• Carl Botvinick, D.D.S.
• Alisa Boucher, MS
• Bow Tie Orthodontics
• Julie Tricia Bowles, RN
• Timothy Kristofer Bradner, PHARM.D.
• Eric Brattinga, PT
• Natasja Yolanda-Lucilla Brattinga

• Otolaryngology Physician in Waterford, MI
• Providers in Waterford, MI by specialty
• Otolaryngology Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 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.