MARIA BOULOS
NPI 1801973771
Radiology - Pediatric Radiology in Latham, NY

Q: What is the provider's specialty?

The provider's specialty is Radiology with taxonomy code 2085P0229X and a focus in Pediatric Radiology.

Active since October 31, 2006PECOS Enrolled

711 TROY SCHENECTADY RD, SUITE 114, LATHAM, NY 12110(518) 786-1600 Get Directions Write a Review

NPPES record last updated: December 6, 2011. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Maria Boulos NPPES

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

MARIA BOULOS (NPI 1801973771) is an individual pediatric radiology provider in Latham, New York, licensed in New York (211666) and active in the NPI registry since October 2006. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1801973771

Entity TypeIndividualFemale

Primary Taxonomy2085P0229X

Provider Legal NameMARIA BOULOS

Location Address711 TROY SCHENECTADY RD, SUITE 114Latham, NY 12110-2442

Mailing Address711 Troy Schenectady Rd, Suite 201Latham, NY 12110-2442

Phone(518) 786-1600

Sole ProprietorNo

Enumeration DateOctober 31, 2006

Last NPPES UpdateDecember 6, 2011

✔ NPI 1801973771 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyRadiology · Pediatric RadiologyAllopathic & Osteopathic Physicians

Taxonomy Code2085P0229X

License✔ Licensed in NY · 211666

Definition

A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood.

Also ListedRadiology · Diagnostic RadiologyTaxonomy 2085R0202X · License 211666 (NY)

711 TROY SCHENECTADY RD, Latham, NY 12110

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Other Identifiers 3

Medicare PINRB2800NY

Medicare UPINH06841NY

Medicaid01991033NY

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Maria Boulos 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.