Sophia Boulukos, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

250691 Issued in NY

Practice address

160 Middle Rd
Sayville, NY 11782-3126

Phone

(631) 379-6728

NPI assigned

Oct 8, 2008

Last updated

Oct 8, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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 NY

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

Internal Medicine

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physicians Private Practice PLLCGroup PAC ID 9436274776, 2 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Catholic Home Care Home health agency, Farmingdale, NY, CCN 337147
• North Shore University Hospital Hospital, Manhasset, NY, CCN 330106
• Good Samaritan Hospital Medical Center Hospital, West Islip, NY, CCN 330286

Merit-based Incentive Payment System (MIPS)

Final score

25.75 of 100Reported as individual

Quality

0

Improvement activities

0

Cost

85.83

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.

• Physicians Private Practice, PLLC

  • Family Medicine Physician
  • Smithtown, NY
  • NPI 1730408923

  Internal Medicine

  Medicare reassignment Care Compare group NPD
• Vytaliz Medical

  • Internal Medicine Physician
  • New City, NY
  • NPI 1568831105
  NPD
• New Wave Cardiology PLLC

  • Specialist
  • Oakdale, NY
  • NPI 1013359561
  NPD (past)

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

• Good Samaritan Hospital Medical Center

  • General Acute Care Hospital
  • West Islip, NY
  • NPI 1902865355
  Care Compare affiliation
• North Shore University Hospital

  • General Acute Care Hospital
  • Manhasset, NY
  • NPI 1366459570
  Care Compare affiliation
• Nursing Sisters Home Care, Inc.

  dba Catholic Health Home Care

  • Home Health Agency
  • Farmingdale, NY
  • NPI 1780670711
  Care Compare affiliation

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1922259878",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 HELM LN",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068109",
            "telephone_number": "631-258-9362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 MIDDLE RD",
            "city": "SAYVILLE",
            "state": "NY",
            "postal_code": "117823126",
            "telephone_number": "631-379-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULUKOS",
        "first_name": "SOPHIA",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "250691",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kate Bishop, LMSW
• Daria Blyskal
• Deborah Joan Boccio, REGISTERED NURSE
• James Thomas Bopp, MD
• Daria Bossert, RN
• Ellen Brady, LMHC
• Mary Lou Brennan, MS
• Olivia Ann Brennan, AU.D.
• Brent Thomas Kempf, D.P.M. (Sayville Foot Care)
• Bright Path NP in Psychiatry

• Internal Medicine Physician in Sayville, NY
• Providers in Sayville, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 8, 2008; 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.