Amanda E Boulis, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA16207 Issued in TX

Practice address

1600 E Jefferson St
Suite 110
Seattle, WA 98122-5698

Phone

(206) 320-7300

Fax

(206) 320-4698

NPI assigned

Feb 12, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, AZ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Yuma Regional Medical CenterGroup PAC ID 2062314826, 367 clinicians

Healthtexas Provider NetworkGroup PAC ID 1355254210, 2,535 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Yuma Regional Medical Center Hospital, Yuma, AZ, CCN 030013
• Baylor Scott & White the Heart Hospital Plano Hospital, Plano, TX, CCN 670025

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aboulis399617@christushealth.direct-ci.net

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.

• Yuma Regional Medical Center

  • General Acute Care Hospital
  • Yuma, AZ
  • NPI 1194706655
  Medicare reassignment Care Compare group NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Dallas, TX
  • NPI 1760488936
  Medicare reassignment Care Compare group
• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225
  Medicare reassignment NPD
• Texas Heart Hospital of the Southwest LLP

  • Nurse Practitioner
  • Plano, TX
  • NPI 1104164755

  Physician Assistant

  Medicare reassignment NPD (past)
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD
• Healthtexas Provider Network

  • Anesthesiology Physician
  • Lakeway, TX
  • NPI 1104714583
  NPD
• Healthtexas Provider Network

  • Family Medicine Physician
  • Colleyville, TX
  • NPI 1235135906
  NPD
• Texas Heart Hospital of the Southwest LLC

  • General Acute Care Hospital
  • Dallas, TX
  • NPI 1609855139
  NPD

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

• Texas Heart Hospital of the Southwest, LLC

  • General Acute Care Hospital
  • Plano, TX
  • NPI 1962504340
  Care Compare affiliation
• Yuma Regional Medical Center

  • General Acute Care Hospital
  • Yuma, AZ
  • NPI 1194706655
  Care Compare affiliation

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723075200000",
    "number": "1992973044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84026",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981248426",
            "telephone_number": "206-320-4476",
            "fax_number": "206-568-7043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 E JEFFERSON ST",
            "address_2": "SUITE 110",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981225698",
            "telephone_number": "206-320-7300",
            "fax_number": "206-320-4698"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2400 S Avenue A",
            "address_purpose": "LOCATION",
            "city": "Yuma",
            "state": "AZ",
            "postal_code": "853647170",
            "country_code": "US",
            "telephone_number": "928-344-2000",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "703 S Fleishel Ave Ste 5000",
            "address_purpose": "LOCATION",
            "city": "Tyler",
            "state": "TX",
            "postal_code": "757012015",
            "country_code": "US",
            "telephone_number": "903-606-6139",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOULIS",
        "first_name": "AMANDA",
        "middle_name": "E",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-12",
        "last_updated": "2024-08-08",
        "certification_date": "2024-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "10362",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "WA",
            "license": "TA10005363",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA16207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alan Curtis Boudousquie, MD
• Hannah Louise Dahlem Boudreaux, PA-C
• Marie Kowalski Boudreaux
• Autum Rose Boulais
• Anthony A Bouldin, MD
• Sara Boulos, RPH
• Caitlin Elise Boulware, MSOT
• Gusty-Lee Boulware, PHD-BCBA-D
• Bouma Orthosport, LLC
• Laura Louise Spiers Bouma, DPT

• Physician Assistant in Seattle, WA
• Providers in Seattle, WA by specialty
• Physician Assistant in Washington

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