DR. ELISABETH BOULOS M.D.
NPI 1124317458
Student in an Organized Health Care Education/Training Program in Pittsburgh, PA
About Dr. Elisabeth Boulos M.d. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. ELISABETH BOULOS M.D. (NPI 1124317458) is an individual student in an organized health care education/training program in Pittsburgh, Pennsylvania and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Elisabeth Boulos M.d. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Elisabeth Boulos reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Boynton Beach, FL 33426
- Reassigned Medicare billing, New York enrollment
- 7,712 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
PITTSBURGH, PA 15213
PITTSBURGH, PA 15213
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 Elisabeth Boulos's NPI number?
The NPI number for Elisabeth Boulos is 1124317458. It was assigned to this individual provider in the NPPES registry on April 7, 2011.
Where is Elisabeth Boulos located?
Elisabeth Boulos practices at 3459 5th Ave NW 628 Upmc, Pittsburgh, PA 15213. The listed phone number is (412) 692-2210.
What is Elisabeth Boulos's specialty?
The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.
Is Elisabeth Boulos enrolled in Medicare?
Yes. Elisabeth Boulos is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Elisabeth Boulos's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Elisabeth Boulos reassigns Medicare benefits to New York University (Boynton Beach, FL). The 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 Elisabeth Boulos's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
When was this NPI record last updated?
The NPPES record for Elisabeth Boulos was last updated on September 20, 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.
# Dr. Elisabeth Boulos, M.D. · NPI 1124317458
Student in an Organized Health Care Education/Training Program provider in Pittsburgh, Pennsylvania. Individual provider, active in the CMS NPPES registry since April 7, 2011.
## Identity
- **NPI:** 1124317458 (Entity type: Individual)
- **Enumerated:** April 7, 2011
- **Primary specialty:** Student in an Organized Health Care Education/Training Program · taxonomy 390200000X
- **Sole proprietor:** Yes
## Practice location
- **Address:** 3459 5TH AVE, NW 628 UPMC, Pittsburgh, PA 15213-3236
- **Phone:** (412) 692-2210
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for durable medical equipment, power mobility devices
- **Bills Medicare through:** New York University (NPI 1285826438, Boynton Beach, FL), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 20, 2017
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Source: [NPI Profile](https://npiprofile.com/npi/1124317458) · Data from the CMS NPPES public registry.