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SUSAN DIANE BOULWARE MD
NPI 1124001946
Pediatrics - Pediatric Endocrinology in New Haven, CT

Active since November 25, 2005PECOS Enrolled
2 CHURCH ST S, SUITE 511, NEW HAVEN, CT 06519(203) 764-9199(203) 764-9149 Get Directions Write a Review

NPPES record last updated: August 4, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Susan Diane Boulware Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SUSAN DIANE BOULWARE MD (NPI 1124001946) is an individual pediatric endocrinology provider in New Haven, Connecticut, licensed in Connecticut (028443) and active in the NPI registry since November 2005. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1124001946
Entity TypeIndividualFemale
Primary Taxonomy2080P0205X
Provider Legal NameSUSAN DIANE BOULWARECredential: MD
Location Address2 CHURCH ST S, SUITE 511New Haven, CT 06519-1717
Mailing Address300 George St, 6th FloorNew Haven, CT 06536-0805
Phone(203) 764-9199
Fax(203) 764-9149
Sole ProprietorNo
Enumeration DateNovember 25, 2005
Last NPPES UpdateAugust 4, 2008
✔ NPI 1124001946 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Pediatric EndocrinologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0205X
License✔ Licensed in CT · 028443
Definition
A pediatrician who provides expert care to infants, children and adolescents who have diseases that result from an abnormality in the endocrine glands (glands which secrete hormones). These diseases include diabetes mellitus, growth failure, unusual size for age, early or late pubertal development, birth defects, the genital region and disorders of the thyroid, the adrenal and pituitary glands.
2 CHURCH ST S, New Haven, CT 06519
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Other Identifiers 3

Medicare ID-Type Unspecified370000625CT
Medicare UPINE96476
Medicaid001284439CT

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Susan Diane Boulware Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06519 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

YALE DERMATOLOGY ASSOCIATES PC
Dermatology
2 CHURCH ST S, SUITE 305
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 789-1249
MS. SUSAN DEBARGE CNM
Advanced Practice Midwife
2 CHURCH ST S, #209
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 787-2264
PAULINA ROSE RD CDN
Dietitian, Registered
2 CHURCH ST S, SUITE 511
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 764-9199
LESLIE JACOBSEN M.D.
Psychiatry & Neurology (Psychiatry)
2 CHURCH ST S, SUITE 207
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 764-8480
MARY SAVOYE RD
Dietitian, Registered (Nutrition, Pediatric)
2 CHURCH ST S, SUITE 404
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 764-6767
DR. DENISE TONZOLA
Obstetrics & Gynecology
2 CHURCH ST S, #209
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 787-2264
ANNE M LOVEJOY PA-C
Physician Assistant (Medical)
2 CHURCH ST S, SUITE 515
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 764-7000
KRISTIN ADAMS SIKES APRN
Nurse Practitioner (Pediatrics)
2 CHURCH ST S, SUITE 404
NEW HAVEN, CT 06519
South Central Connecticut Planning Region (203) 764-6747

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 Susan Boulware's NPI number?

The NPI number for Susan Boulware is 1124001946. It was assigned to this individual provider in the NPPES registry on November 25, 2005.

Where is Susan Boulware located?

Susan Boulware practices at 2 Church St S Suite 511, New Haven, CT 06519. The listed phone number is (203) 764-9199.

What is Susan Boulware's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Endocrinology, with taxonomy code 2080P0205X.

Is Susan Boulware enrolled in Medicare?

Yes. Susan Boulware is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Susan Boulware was last updated on August 4, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 17 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.