DR. DANY BOULOS M.D. NPI 1780830703

NPI Information

  • NPI: 1780830703
  • Provider Name: DR. DANY BOULOS, M.D.
  • Classification: Family Medicine - 207Q00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 11000 ROOSEVELT BLVD
    360
    PHILADELPHIA, PA
    ZIP 19116
  • Phone: (215) 677-1475

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NPI Details

DR. Dany Boulos, M.D. is a family medicine in Philadelphia, PA with 21 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. DR. Dany Boulos, M.D. NPI is 1780830703. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

11000 ROOSEVELT BLVD
360
PHILADELPHIA, PA
ZIP 19116-961
Phone: (215) 677-1475
Fax: (215) 677-3082

The NPI 1780830703 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • New patient office or other outpatient visit, 30-44 minutes (HCPCS:99203)
  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Amplifed dna or rna probe detection of severe acute respiratory syndrome coronavirus 2 (covid-19) antigen (HCPCS:87635)

The enumeration date for this NPI number is 8/11/2008 and was last updated on 3/20/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207P00000XEmergency Medicine036141752ILLINOISNo
2207Q00000XFamily MedicineMD453720PENNSYLVANIANo
3207Q00000XFamily Medicine01068800AINDIANANo
4207Q00000XFamily Medicine036141752ILLINOISYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000000718849OTHERINDIANAANTHEM
2201024290MEDICAIDINDIANA
3036141752OTHERILLINOISSTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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