TIFFANY LEE BOULANGER AGACNP
NPI 1700308509
Nurse Practitioner - Acute Care in Marietta, GA

Q: 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.

Q: What is Tiffany Boulanger's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Acute Care, with taxonomy code 363LA2100X.

Q: When was this NPI record last updated?

The NPPES record for Tiffany Boulanger was last updated on March 28, 2025. NPI Profile syncs with the weekly NPPES data releases published by CMS.

Active since July 13, 2017PECOS EnrolledAccepts Medicare Assignment

400 TOWER RD NE STE 200, MARIETTA, GA 30060(770) 422-1372 Get Directions Write a Review

NPPES record last updated: March 28, 2025. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 28, 2025, Aug 14, 2017, Jul 13, 2017 (3 updates tracked since 2017).

On this page

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

NPI1700308509

Entity TypeIndividualFemale

Primary Taxonomy363LA2100X

Provider Legal NameTIFFANY LEE BOULANGERCredential: AGACNP

Location Address400 TOWER RD NE STE 200Marietta, GA 30060-9412

Mailing Address7400 Abercorn Street, Ste 704 Box 104Savannah, GA 31406-2454 · (912) 232-9700 · Fax (912) 748-0270

Phone(770) 422-1372

Sole ProprietorNo

Medical School CMSOtherGraduated 2017

Enumeration DateJuly 13, 2017

Last NPPES UpdateMarch 28, 20253 updates tracked since enumeration

NPPES CertifiedMarch 28, 2025

✔ NPI 1700308509 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Acute CarePhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363LA2100X

License✔ Licensed in GA · 236517

400 TOWER RD NE STE 200, Marietta, GA 30060

Open in Google Maps ↗

Secondary Practice Location 1

Location 112345 Mercy BlvdSavannah, GA 31419-3436 · Phone (912) 927-3046

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..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

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.

PECOS PAC ID4981978376

PECOS Enrollment IDI20170925000300

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 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.

Injection, inclisiran, 1 mg J1306

Inclisiran is an injection administered to lower cholesterol levels. It works by blocking the production of LDL (bad cholesterol) in your liver. This medicine is often used when diet changes and other medications have not been effective.

7,384 services21 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

165 services50 patients

Infusion into a vein for therapy, prevention, or diagnosis, 1 hour or less 96365

This is a procedure where a medical professional inserts a small tube into your vein to deliver medication, nutrients, or fluids directly into your bloodstream. This can be for treatment, prevention, or diagnosis. The process typically takes less than an hour.

100 services17 patients

Administration of chemotherapy into vein, 1 hour or less 96413

Chemotherapy is a treatment that uses drugs to destroy cancer cells. When administered into a vein, it's often through an IV. This procedure usually lasts 1 hour or less. You may feel a slight pinch as the needle is inserted, but it's generally painless.

27 services11 patients

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, GA

4/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number110035

Location677 Church StreetMarietta, GA 30060 · Cobb County

Emergency services Birthing friendly

Wellstar Paulding Medical Center

Acute Care Hospitals · Hiram, GA

4/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number110042

Location2518 Jimmy Lee Smith ParkwayHiram, GA 30141 · Paulding County

Physician 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.

New Patient

$88.06 typical visit price

range $56.84 – $172.43

Typical copayment $22.01 (range $14.21 – $43.10)

Most-billed visit code 99203

Established Patient

$100.20 typical visit price

range $18.22 – $140.40

Typical copayment $25.05 (range $4.55 – $35.10)

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.

Leave this field empty

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.

SARIKA MISHRA NP

Nurse Practitioner (Acute Care)