TIFFANY LEE BOULANGER AGACNP
NPI 1700308509
Nurse Practitioner - Acute Care in Marietta, GA
About Tiffany Lee Boulanger Agacnp NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
TIFFANY LEE BOULANGER AGACNP (NPI 1700308509) is an individual acute care provider in Marietta, Georgia, licensed in Georgia (236517) and active in the NPI registry since July 2017. She is enrolled in Medicare PECOS, is affiliated with Wellstar Kennestone Regional Medical Center, and maintains a secondary practice location in Savannah.
NPPES Registry Identity
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Tiffany Lee Boulanger Agacnp 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.
Medicare Billing Reassignments
6Medicare enrollment records show Tiffany Boulanger reassigns Medicare billing to 6 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Marietta, GA 30060
- Reassigned Medicare billing, Georgia enrollment
- 3,885 clinicians in this Medicare group
Norcross, GA 30093
- Reassigned Medicare billing, Georgia enrollment
- 78 clinicians in this Medicare group
Columbus, GA 31909
- Reassigned Medicare billing, Georgia enrollment
- 13 clinicians in this Medicare group
Mount Juliet, TN 37122
- Reassigned Medicare billing, Georgia enrollment
- 14 clinicians in this Medicare group
Boston, MA 02114
- Reassigned Medicare billing, Massachusetts enrollment
- 6,234 clinicians in this Medicare group
Boston, MA 02114
- Reassigned Medicare billing, Massachusetts enrollment
- 6,360 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.
Areas of Expertise CMS Part B claims 4
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.
Hospital Affiliations CMS Care Compare 2
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Wellstar Kennestone Regional Medical Center
Acute Care Hospitals · Marietta, GAWellstar Paulding Medical Center
Acute Care Hospitals · Hiram, GAPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 30060 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
MARIETTA, GA 30060
MARIETTA, GA 30060
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 Tiffany Boulanger's NPI number?
The NPI number for Tiffany Boulanger is 1700308509. It was assigned to this individual provider in the NPPES registry on July 13, 2017.
Where is Tiffany Boulanger located?
Tiffany Boulanger practices at 400 Tower Rd NE Ste 200, Marietta, GA 30060. The listed phone number is (770) 422-1372.
What is Tiffany Boulanger's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.
Is Tiffany Boulanger enrolled in Medicare?
Yes. Tiffany Boulanger 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.
Which organizations bill Medicare for Tiffany Boulanger's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Tiffany Boulanger reassigns Medicare benefits to 6 organizations: Wellstar Medical Group, LLC (Marietta, GA), Pruitthealth Physicians Services, LLC (Norcross, GA), Renew Wound Care Of Georgia LLC (Columbus, GA), Regional Healthcare Group LLC (Mount Juliet, TN), The General Hospital Corporation (Boston, MA) and 1 more organization, listed in the Medicare section above. 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 Tiffany Boulanger's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Tiffany Boulanger accept?
Health plans from Alliant Health Plans, Inc. list Tiffany Boulanger 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 Tiffany Boulanger affiliated with any hospitals?
According to CMS data, Tiffany Boulanger is affiliated with Wellstar Kennestone Regional Medical Center and Wellstar Paulding Medical Center.
When was this NPI record last updated?
The NPPES record for Tiffany Boulanger was last updated on March 28, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.
# Tiffany Lee Boulanger, AGACNP · NPI 1700308509
Acute Care physician in Marietta, Georgia. Individual provider, active in the CMS NPPES registry since July 13, 2017.
## Identity
- **NPI:** 1700308509 (Entity type: Individual)
- **Enumerated:** July 13, 2017
- **Primary specialty:** Nurse Practitioner - Acute Care · taxonomy 363LA2100X
- **State license:** 236517 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 400 TOWER RD NE STE 200, Marietta, GA 30060-9412
- **Phone:** (770) 422-1372
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 6 organizations under Medicare reassignment (form CMS-855R): Wellstar Medical Group, LLC (NPI 1912203555, Marietta, GA); Pruitthealth Physicians Services, LLC (NPI 1043676299, Norcross, GA); Renew Wound Care Of Georgia LLC (NPI 1245907971, Columbus, GA); Regional Healthcare Group LLC (NPI 1407587363, Mount Juliet, TN); The General Hospital Corporation (NPI 1023049236, Boston, MA); and 1 more · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2017
## Record status
- **NPPES last updated:** March 28, 2025
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Source: [NPI Profile](https://npiprofile.com/npi/1700308509) · Data from the CMS NPPES public registry.