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DR. JEREMY BOUSSELOT M.D.
NPI 1558660811
Internal Medicine in Arlington, VA

Active since March 24, 2011PECOS EnrolledAccepts Medicare Assignment
77.36/100
CMS Quality Rating
1701 N GEORGE MASON DR, ARLINGTON, VA 22205(703) 717-4400(703) 717-4401 Get Directions Write a Review

NPPES record last updated: March 28, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Dr. Jeremy Bousselot M.d. NPPES

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

DR. JEREMY BOUSSELOT M.D. (NPI 1558660811) is an individual internal medicine provider in Arlington, Virginia, licensed in Virginia (0101255360) and active in the NPI registry since March 2011. He is enrolled in Medicare PECOS, is affiliated with Virginia Hospital Center, and is a graduate of Georgetown University School Of Medicine (2011).

NPPES Registry Identity

NPI1558660811
Entity TypeIndividualMale
Primary Taxonomy207R00000X
Provider Legal NameDR. JEREMY BOUSSELOTCredential: M.D.
Location Address1701 N GEORGE MASON DRArlington, VA 22205-3610
Mailing Address1625 N George Mason Dr Ste 345Arlington, VA 22205-3690 · (703) 717-4400 · Fax (703) 717-4401
Phone(703) 717-4400
Fax(703) 717-4401
Sole ProprietorYes
Medical School CMSGeorgetown University School Of MedicineGraduated 2011
Enumeration DateMarch 24, 2011
Last NPPES UpdateMarch 28, 2022
NPPES CertifiedMarch 28, 2022
✔ NPI 1558660811 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
License✔ Licensed in VA · 0101255360
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedHospitalistTaxonomy 208M00000X · License 0101255360 (VA)
1701 N GEORGE MASON DR, Arlington, VA 22205
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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

Dr. Jeremy Bousselot M.d. 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.

PECOS PAC ID1456579093
PECOS Enrollment IDI20140825000217
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.

Areas of Expertise CMS Part B claims 2

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
82 services80 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
36 services36 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Virginia Hospital Center

Acute Care Hospitals · Arlington, VA
5/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number490050
Location1701 North George Mason DriveArlington, VA 22205 · Arlington County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 22205 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
$147.85 typical visit price
range $65.18 – $194.86
Typical copayment $36.96 (range $16.29 – $48.71)
Most-billed visit code 99204
Established Patient
$113.72 typical visit price
range $21.40 – $158.88
Typical copayment $28.43 (range $5.35 – $39.72)
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.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

77.36/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality80.82
Promoting Interoperability87
Improvement Activities40
Cost54.56

Referred Medical Equipment & Supplies CMS DME claims 5

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Tubing with integrated heating element for use with positive airway pressure device A4604
DME-Other DME · category DE001N
3 suppliers19 claims19 services$31.81 avg. paid by Medicare
Cushion for use on nasal mask interface, replacement only, each A7032
DME-Other DME · category DE001N
3 suppliers12 claims72 services$14.77 avg. paid by Medicare
Nasal interface (mask or cannula type) used with positive airway pressure device, with or without head strap A7034
DME-Other DME · category DE001N
3 suppliers13 claims13 services$49.12 avg. paid by Medicare
Headgear used with positive airway pressure device A7035
DME-Other DME · category DE001N
2 suppliers11 claims11 services$14.33 avg. paid by Medicare
Filter, disposable, used with positive airway pressure device A7038
DME-Other DME · category DE001N
3 suppliers18 claims108 services$1.69 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

CHRISTINA WALD RN
Nurse Anesthetist, Certified Registered
1701 N GEORGE MASON DR
ARLINGTON, VA 22205
Arlington County (714) 904-0496
DR. BRIAN CARUTH PHARMD
Pharmacist
1701 N GEORGE MASON DR
ARLINGTON, VA 22205
Arlington County (703) 558-5000
MS. DEBORAH ANNA FISCHETTI CNNP
Nurse Practitioner (Neonatal, Critical Care)
1701 N GEORGE MASON DR
ARLINGTON, VA 22205
Arlington County (703) 558-6675
DR. MUSHFIQUE AHMED MD
Anesthesiology
1701 N GEORGE MASON DR
ARLINGTON, VA 22205
Arlington County (703) 558-2438
MR. DAVID W GLOSE II CSFA
Specialist/Technologist, Other (Surgical Assistant)
1701 N GEORGE MASON DR
ARLINGTON, VA 22205
Arlington County (703) 558-5000
DR. MICHAEL ANDREW COLE M.D.
Internal Medicine (Critical Care Medicine)
1701 N GEORGE MASON DR, INTENSIVE CARE UNIT
ARLINGTON, VA 22205
Arlington County (571) 244-8410
EMALEE BLACK PHARMD
Pharmacist
1701 N GEORGE MASON DR
ARLINGTON, VA 22205
Arlington County (703) 558-5000
EFRAIN A. MARTINEZ CRNA
Nurse Anesthetist, Certified Registered
1701 N GEORGE MASON DR, SUITE 2D
ARLINGTON, VA 22205
Arlington County (703) 558-5000

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 Jeremy Bousselot's NPI number?

The NPI number for Jeremy Bousselot is 1558660811. It was assigned to this individual provider in the NPPES registry on March 24, 2011.

Where is Jeremy Bousselot located?

Jeremy Bousselot practices at 1701 N George Mason Dr, Arlington, VA 22205. The listed phone number is (703) 717-4400.

What is Jeremy Bousselot's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Jeremy Bousselot enrolled in Medicare?

Yes. Jeremy Bousselot 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.

Is Jeremy Bousselot affiliated with any hospitals?

According to CMS data, Jeremy Bousselot is affiliated with Virginia Hospital Center.

When was this NPI record last updated?

The NPPES record for Jeremy Bousselot was last updated on March 28, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.