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EMMANUEL BOULOUTE NP
NPI 1942608674
Nurse Practitioner in Dorchester, MA

Active since December 11, 2014PECOS EnrolledAccepts Medicare Assignment
637 WASHINGTON ST, DORCHESTER, MA 02124(617) 825-9660(617) 288-7898 Get Directions Write a Review

NPPES record last updated: December 11, 2014. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Emmanuel Bouloute Np NPPES

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

EMMANUEL BOULOUTE NP (NPI 1942608674) is an individual nurse practitioner in Dorchester, Massachusetts, licensed in Massachusetts (RN2284528) and active in the NPI registry since December 2014. He is enrolled in Medicare PECOS, is affiliated with Boston Medical Center, and is a graduate of Other (2014).

NPPES Registry Identity

NPI1942608674
Entity TypeIndividualMale
Primary Taxonomy363L00000X
Provider Legal NameEMMANUEL BOULOUTECredential: NP
Location Address637 WASHINGTON STDorchester, MA 02124-3510
Mailing Address637 Washington StDorchester, MA 02124-3510 · (617) 825-9660 · Fax (617) 288-7898
Phone(617) 825-9660
Fax(617) 288-7898
Sole ProprietorNo
Medical School CMSOtherGraduated 2014
Enumeration DateDecember 11, 2014
✔ NPI 1942608674 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in MA · RN2284528
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
637 WASHINGTON ST, Dorchester, MA 02124
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include CareSource (Common Ground Healthcare), Taro Health.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

Emmanuel Bouloute Np 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 ID8022326461
PECOS Enrollment IDI20151005000305
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.

Medicare Billing Reassignments

3

Medicare enrollment records show Emmanuel Bouloute reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Codman Square Health Center Inc
Same address
Community Health
637 WASHINGTON ST
Dorchester Center, MA 02124
  • Reassigned Medicare billing, Massachusetts enrollment
  • 91 clinicians in this Medicare group
NPI 1396808309 (617) 825-9660
Matrix Medical Plus
941 mi
Nurse Practitioner
424 CHURCH ST STE 2600
Nashville, TN 37219
  • Reassigned Medicare billing, Massachusetts enrollment
  • 125 clinicians in this Medicare group
NPI 1376973461 (877) 564-3627
Signify Health Medical Associates, PLLC
1,546 mi
General Practice
4055 VALLEY VIEW LN STE 700
Dallas, TX 75244
  • Reassigned Medicare billing, Massachusetts enrollment
  • 203 clinicians in this Medicare group
NPI 1750845863 (972) 715-3800

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Hospital Affiliations CMS Care Compare

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

Boston Medical Center

Acute Care Hospitals · Boston, MA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number220031
Location1 Boston Medical Center PlaceBoston, MA 02118 · Suffolk County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 02124 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
$97.64 typical visit price
range $63.72 – $189.86
Typical copayment $24.41 (range $15.93 – $47.46)
Most-billed visit code 99203
Established Patient
$111.18 typical visit price
range $21.07 – $155.29
Typical copayment $27.79 (range $5.26 – $38.82)
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.

MIA ISABEL RODRIGUEZ DDS
Student in an Organized Health Care Education/Training Program
637 WASHINGTON ST
DORCHESTER, MA 02124
Suffolk County (617) 825-9660
DR. MARK CYPRIAN BEAUMONT MD
Family Medicine
637 WASHINGTON ST
DORCHESTER CENTER, MA 02124
Suffolk County (617) 825-9660
SHANNON LYONS RN, FNP
Nurse Practitioner (Family)
637 WASHINGTON ST
BOSTON, MA 02124
Suffolk County (617) 825-9660
MS. MARIE ANDREE PIERRE-VICTOR MSW, LICSW
Social Worker
637 WASHINGTON ST
DORCHESTER CENTER, MA 02124
Suffolk County (617) 822-8211
JENNIFER GARLIN LCSW
Social Worker
637 WASHINGTON ST
DORCHESTER CENTER, MA 02124
Suffolk County (617) 825-9660
MS. DENISE MARIE CROKEN NP
Nurse Practitioner (Family)
637 WASHINGTON ST
DORCHESTER, MA 02124
Suffolk County (617) 825-9660
BOSTON MEDICAL CENTER CORPORATION
Pharmacy (Community/Retail Pharmacy)
637 WASHINGTON ST
DORCHESTER, MA 02124
Suffolk County (617) 638-8150
BOSTON MEDICAL CENTER CORPORATION
Pharmacy (Community/Retail Pharmacy)
637 WASHINGTON ST
DORCHESTER, MA 02124
Suffolk County (617) 638-8150

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 Emmanuel Bouloute's NPI number?

The NPI number for Emmanuel Bouloute is 1942608674. It was assigned to this individual provider in the NPPES registry on December 11, 2014.

Where is Emmanuel Bouloute located?

Emmanuel Bouloute practices at 637 Washington St, Dorchester, MA 02124. The listed phone number is (617) 825-9660.

What is Emmanuel Bouloute's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Emmanuel Bouloute enrolled in Medicare?

Yes. Emmanuel Bouloute 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 Emmanuel Bouloute's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Emmanuel Bouloute reassigns Medicare benefits to 3 organizations: Codman Square Health Center Inc (Dorchester Center, MA), Matrix Medical Plus (Nashville, TN) and Signify Health Medical Associates, PLLC (Dallas, TX). 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 Emmanuel Bouloute's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Emmanuel Bouloute accept?

Health plans from CareSource (Common Ground Healthcare) and Taro Health list Emmanuel Bouloute 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 Emmanuel Bouloute affiliated with any hospitals?

According to CMS data, Emmanuel Bouloute is affiliated with Boston Medical Center.

When was this NPI record last updated?

The NPPES record for Emmanuel Bouloute was last updated on December 11, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.