BOULOUTE HEALTHCARE SERVICES, LLC
NPI 1104343532
Podiatrist in Woodbridge, VA
About Bouloute Healthcare Services, Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
BOULOUTE HEALTHCARE SERVICES, LLC (NPI 1104343532) is a healthcare organization registered as a podiatrist in Woodbridge, Virginia and active in the NPI registry since August 2017. The organization lists Owmy Bouloute, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Bouloute Healthcare Services, Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
Medicare enrollment records show 1 clinician reassigns Medicare billing to Bouloute Healthcare Services, LLC, which bills Medicare for the services this clinician delivers.
Clinician (1)
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Bouloute Healthcare Services, LLC's NPI number?
The NPI number for Bouloute Healthcare Services, LLC is 1104343532. It was assigned to this organization in the NPPES registry on August 25, 2017.
Where is Bouloute Healthcare Services, LLC located?
Bouloute Healthcare Services, LLC is located at 5049 Anchorstone Dr, Woodbridge, VA 22192. The listed phone number is (678) 517-4214.
What is Bouloute Healthcare Services, LLC's specialty?
The primary specialty registered for this NPI is Podiatrist with taxonomy code 213E00000X.
Is Bouloute Healthcare Services, LLC enrolled in Medicare?
Yes. Bouloute Healthcare Services, LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Bouloute Healthcare Services, LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Podiatry) reassigns their Medicare billing to Bouloute Healthcare Services, LLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Bouloute Healthcare Services, LLC was last updated on August 25, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# Bouloute Healthcare Services, Llc · NPI 1104343532
Podiatrist organization in Woodbridge, Virginia. Organization record, active in the CMS NPPES registry since August 25, 2017.
## Identity
- **NPI:** 1104343532 (Entity type: Organization)
- **Enumerated:** August 25, 2017
- **Primary specialty:** Podiatrist · taxonomy 213E00000X
- **Organization subpart:** No
- **Authorized official:** Owmy Bouloute, OWNER
## Practice location
- **Address:** 5049 ANCHORSTONE DR, Woodbridge, VA 22192-8320
- **Phone:** (678) 517-4214
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 1 clinician (Podiatry) reassigns Medicare billing to this organization (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** August 25, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1104343532) · Data from the CMS NPPES public registry.