Spyridon Boukouris, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

4301086057 Issued in MI

Practice address

22101 Moross Rd
Department of Emergency Medicine
Detroit, MI 48236-2148

Phone

(313) 343-8797

Fax

(313) 343-7620

NPI assigned

May 18, 2007

Sex

Male

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 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

Emergency Medicine

Education

Wayne State University School of Medicine, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergency Professionals of Michigan PCGroup PAC ID 3274767371, 49 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Beaumont Hospital - Dearborn Hospital, Dearborn, MI, CCN 230020

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• Emergency Professionals of Michigan, P.C.

  • Emergency Medicine Physician
  • Dearborn, MI
  • NPI 1952740656
  Medicare reassignment Care Compare group NPD
• Degara App, PLLC

  • Emergency Medicine Physician
  • Lansing, MI
  • NPI 1265976971
  Medicare reassignment NPD
• Observation Emergency Physicians, P.C.

  • Emergency Medicine Physician
  • Detroit, MI
  • NPI 1497920524
  Medicare reassignment NPD
• Emergency Department Physicians, P.C.

  • Emergency Medicine Physician
  • Detroit, MI
  • NPI 1225083595
  Medicare reassignment
• Independent Emergency Physicians, P.C.

  • Emergency Medical Services (Emergency Medicine) Physician
  • Southfield, MI
  • NPI 1780791343
  NPD (past)

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

• Oakwood Healthcare Inc

  dba Beaumont Outpatient Diabetes Education

  • Community Health Clinic/Center
  • Dearborn, MI
  • NPI 1790414670

  Hospital

  Care Compare affiliation
• Oakwood Healthcare, Inc.

  dba Beaumont Hospital - Dearborn

  • General Acute Care Hospital
  • Dearborn, MI
  • NPI 1740230119
  Care Compare affiliation

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

{
    "created_epoch": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1982812657",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-8797",
            "fax_number": "313-343-7620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22101 MOROSS RD",
            "address_2": "DEPARTMENT OF EMERGENCY MEDICINE",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482362148",
            "telephone_number": "313-343-8797",
            "fax_number": "313-343-7620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUKOURIS",
        "first_name": "SPYRIDON",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "4301086057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alison Tisack Boucher, M.D.
• Cindy Neka Boudreaux, MD
• Renee Bouey, PH.D.
• Jose Antonio Bouffard, M.D.
• Shelly Lauren Bouie, RN
• Jamila B Boulaalam, DDS
• Asmaa Boulehia
• Boulevard Manor L.L.C.
• Boulevard Temple Care Center, LLC
• Matthew Boulis, DO

• Emergency Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Emergency Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.