1. Home
  2. Directory
  3. Michigan
  4. Lansing
  5. Pediatrics
  6. NPI Profile

SAMAR MARIE BOULOS D.O.
NPI 1689067829
Pediatrics in Lansing, MI

Active since March 12, 2015PECOS Enrolled
1717 N HIGH ST, LANSING, MI 48906(517) 371-1700(517) 371-4245 Get Directions Write a Review

NPPES record last updated: April 22, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 22, 2022, Dec 7, 2018 (2 updates tracked since 2018).

About Samar Marie Boulos D.o. NPPES

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

SAMAR MARIE BOULOS D.O. (NPI 1689067829) is an individual pediatrics provider in Lansing, Michigan, licensed in Michigan (5101024418) and active in the NPI registry since March 2015. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1689067829
Entity TypeIndividualFemale
Primary Taxonomy208000000X
Provider Legal NameSAMAR MARIE BOULOSCredential: D.O.
Location Address1717 N HIGH STLansing, MI 48906-4597
Mailing Address1717 N High StLansing, MI 48906-4597 · (517) 371-1700 · Fax (517) 371-4245
Phone(517) 371-1700
Fax(517) 371-4245
Sole ProprietorNo
Enumeration DateMarch 12, 2015
Last NPPES UpdateApril 22, 20222 updates tracked since enumeration
NPPES CertifiedApril 22, 2022
✔ NPI 1689067829 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in MI · 5101024418
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
1717 N HIGH ST, Lansing, MI 48906
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Samar Marie Boulos D.o. 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 48906 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
$84.74 typical visit price
range $54.34 – $166.68
Typical copayment $21.18 (range $13.58 – $41.67)
Most-billed visit code 99203
Established Patient
$96.44 typical visit price
range $17.09 – $135.40
Typical copayment $24.11 (range $4.27 – $33.85)
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.

MISS MALARY JEAN THORSBY
Student in an Organized Health Care Education/Training Program
1717 N HIGH ST
LANSING, MI 48906
Ingham County (517) 372-4700
MADISON BOYLE
Counselor (Addiction (Substance Use Disorder))
1717 N HIGH ST
LANSING, MI 48906
Ingham County (517) 372-4700
ANNA MARIE SEVENSKI
Social Worker
1717 N HIGH ST
LANSING, MI 48906
Ingham County (517) 372-4700
MRS. STEPHANIE LYNN SCHULTZ NP
Nurse Practitioner (Family)
1717 N HIGH ST
LANSING, MI 48906
Ingham County (517) 253-8243
ROBERT POWELL LMSW
Social Worker
1717 N HIGH ST
LANSING, MI 48906
Ingham County (517) 372-4700
ROSA CASTANON
Social Worker
1717 N HIGH ST
LANSING, MI 48906
Ingham County (517) 372-4700
ALEXIS DAUGHERTY
Social Worker (Clinical)
1717 N HIGH ST
LANSING, MI 48906
Ingham County (517) 372-4700
MINDORA ROBINSON DP-C
Counselor (Addiction (Substance Use Disorder))
1717 N HIGH ST
LANSING, MI 48906
Ingham County (517) 372-4700

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 Samar Boulos's NPI number?

The NPI number for Samar Boulos is 1689067829. It was assigned to this individual provider in the NPPES registry on March 12, 2015.

Where is Samar Boulos located?

Samar Boulos practices at 1717 N High St, Lansing, MI 48906. The listed phone number is (517) 371-1700.

What is Samar Boulos's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Samar Boulos enrolled in Medicare?

Yes. Samar Boulos is registered in the Medicare PECOS enrollment system.

What insurance does Samar Boulos accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Samar 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.

When was this NPI record last updated?

The NPPES record for Samar Boulos was last updated on April 22, 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.