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THERESE BOULAY
NPI 1366318149
Nurse Practitioner - Family in Hollywood, FL

Active since October 16, 2025PECOS Enrolled
11011 SHERIDAN ST STE 106, HOLLYWOOD, FL 33026(786) 303-9175 Get Directions Write a Review

NPPES record last updated: October 16, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Therese Boulay NPPES

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

THERESE BOULAY (NPI 1366318149) is an individual family provider in Hollywood, Florida, licensed in Florida (11042947) and active in the NPI registry since October 2025. She is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1366318149
Entity TypeIndividualFemale
Primary Taxonomy363LF0000X
Provider Legal NameTHERESE BOULAY
Location Address11011 SHERIDAN ST STE 106Hollywood, FL 33026-1501
Mailing Address15121 Nw 7th CtPembroke Pines, FL 33028-1856 · (786) 303-9175
Phone(786) 303-9175
Sole ProprietorYes
Medical School CMSOtherGraduated 2025
Enumeration DateOctober 16, 2025
NPPES CertifiedOctober 16, 2025
✔ NPI 1366318149 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in FL · 11042947
11011 SHERIDAN ST STE 106, Hollywood, FL 33026
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Therese Boulay is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID8325523202
PECOS Enrollment IDI20260328000456
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.

Medicare Billing Reassignments

2

Medicare enrollment records show Therese Boulay reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Primary Care Solutions Jacksonville LLC
298 mi
Family Medicine
42 DAVIN CT
Ponte Vedra Beach, FL 32082
  • Reassigned Medicare billing, Florida enrollment
  • 21 clinicians in this Medicare group
NPI 1407555154 (904) 490-0264
Infinite Medical PC
1,195 mi
Family Medicine
7 CREEK LN
Bristol, RI 02809
  • Reassigned Medicare billing, Connecticut, Florida, Nebraska, New York, Ohio and Vermont enrollments
  • 69 clinicians in this Medicare group
NPI 1407483175 (718) 964-6161

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 33026 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
$91.69 typical visit price
range $58.56 – $179.05
Typical copayment $22.92 (range $14.64 – $44.76)
Most-billed visit code 99203
Established Patient
$103.21 typical visit price
range $18.44 – $144.68
Typical copayment $25.80 (range $4.61 – $36.17)
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 5

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

JULIEANNE LAURENTE CRNA
Nurse Anesthetist, Certified Registered
11011 SHERIDAN ST STE 106
HOLLYWOOD, FL 33026
Broward County (954) 435-0101
RACHEL BLANTON
Nurse Anesthetist, Certified Registered
11011 SHERIDAN ST STE 106
HOLLYWOOD, FL 33026
Broward County (954) 435-0101
KELLIE K BIRCH CRNA
Nurse Anesthetist, Certified Registered
11011 SHERIDAN ST STE 106
HOLLYWOOD, FL 33026
Broward County (954) 435-0101
LORI S. TOLSON CRNA
Nurse Anesthetist, Certified Registered
11011 SHERIDAN ST STE 106
HOLLYWOOD, FL 33026
Broward County (954) 435-0101
GALLOWAY ANESTHESIA ASSOCIATES LLC
Nurse Anesthetist, Certified Registered
11011 SHERIDAN ST STE 106
HOLLYWOOD, FL 33026
Broward County (305) 468-4180

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 Therese Boulay's NPI number?

The NPI number for Therese Boulay is 1366318149. It was assigned to this individual provider in the NPPES registry on October 16, 2025.

Where is Therese Boulay located?

Therese Boulay practices at 11011 Sheridan St Ste 106, Hollywood, FL 33026. The listed phone number is (786) 303-9175.

What is Therese Boulay's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Therese Boulay enrolled in Medicare?

Yes. Therese Boulay is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Therese Boulay's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Therese Boulay reassigns Medicare benefits to 2 organizations: Primary Care Solutions Jacksonville LLC (Ponte Vedra Beach, FL) and Infinite Medical PC (Bristol, RI). Each 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 Therese Boulay'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 Therese Boulay was last updated on October 16, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 12 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.