AMANDA BOULOS
NPI 1194503722
Physician Assistant - Surgical in Marietta, GA
About Amanda Boulos NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
AMANDA BOULOS (NPI 1194503722) is an individual surgical provider in Marietta, Georgia, licensed in Georgia (12976) and active in the NPI registry since September 2023. She is enrolled in Medicare PECOS, is affiliated with Northside Hospital Cherokee, and is a graduate of Other (2024).
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Amanda Boulos is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Northside Hospital Cherokee
Acute Care Hospitals · Canton, GAOther Providers at the Same Location NPPES 4
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
MARIETTA, GA 30060
MARIETTA, GA 30060
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 Amanda Boulos's NPI number?
The NPI number for Amanda Boulos is 1194503722. It was assigned to this individual provider in the NPPES registry on September 15, 2023.
Where is Amanda Boulos located?
Amanda Boulos practices at 1371 Church Street Ext NE Suite 200, Marietta, GA 30060. The listed phone number is (678) 481-0579.
What is Amanda Boulos's specialty?
The primary specialty registered for this NPI is Physician Assistant, specializing in Surgical, with taxonomy code 363AS0400X.
Is Amanda Boulos enrolled in Medicare?
Yes. Amanda Boulos is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.
What insurance does Amanda Boulos accept?
Health plans from Alliant Health Plans, Inc. list Amanda Boulos as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
Is Amanda Boulos affiliated with any hospitals?
According to CMS data, Amanda Boulos is affiliated with Northside Hospital Cherokee.
When was this NPI record last updated?
The NPPES record for Amanda Boulos was last updated on April 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.
# Amanda Boulos · NPI 1194503722
Surgical physician in Marietta, Georgia. Individual provider, active in the CMS NPPES registry since September 15, 2023.
## Identity
- **NPI:** 1194503722 (Entity type: Individual)
- **Enumerated:** September 15, 2023
- **Primary specialty:** Physician Assistant - Surgical · taxonomy 363AS0400X
- **State license:** 12976 (Georgia)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 1371 CHURCH STREET EXT NE, SUITE 200, Marietta, GA 30060-7913
- **Phone:** (678) 481-0579
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Medical school:** Other, class of 2024
## Record status
- **NPPES last updated:** April 28, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1194503722) · Data from the CMS NPPES public registry.