Amira Boulos Fanous-paul, MD is a medicare enrolled "Pathology - Anatomic Pathology & Clinical Pathology" physician in Roswell, Georgia. She graduated from medical school in 1985 and has 39 years of diverse experience with area of expertise as Pathology. She is a member of the group practice Wellstar Medical Group, Llc and her current practice location is
3000 Hospital Blvd, Roswell, Georgia. You can reach out to her office (for appointments etc.) via phone at
(770) 751-2500.
Amira Boulos Fanous-paul is licensed to practice in Georgia (license number 77475) and she also participates in the medicare program. She
accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1326007865.
Physician's Profile
Full Name | Amira Boulos Fanous-paul |
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Gender | Female |
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Speciality | Pathology |
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Experience | 39 Years |
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Location | 3000 Hospital Blvd, Roswell, Georgia |
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Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Medical Education and Training:
- Amira Boulos Fanous-paul graduated from medical school in 1985
NPI Data:
- NPI Number: 1326007865
- Provider Enumeration Date: 03/22/2006
- Last Update Date: 09/26/2019
Medicare PECOS Information:
- PECOS PAC ID: 4183644321
- Enrollment ID: I20170307002121
Medical Identifiers
Medical identifiers for Amira Boulos Fanous-paul such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1326007865 | NPI | - | NPPES |
177879701 | Medicaid | TX | |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
207ZP0105X | Pathology - Clinical Pathology/laboratory Medicine | 38616 (Kentucky) | Secondary |
207ZP0102X | Pathology - Anatomic Pathology & Clinical Pathology | 77475 (Georgia) | Primary |
Medical Facilities Affiliation
Group Practice Association
Group Practice Name | Group PECOS PAC ID | No. of Members |
Wellstar Medical Group, Llc | 6709065402 | 1917 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Amira Boulos Fanous-paul allows following entities to bill medicare on her behalf.
Entity Name | Wellstar Medical Group, Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1558664003 PECOS PAC ID: 6709065402 Enrollment ID: O20110127000374 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Amira Boulos Fanous-paul is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Amira Boulos Fanous-paul, MD 3000 Hospital Blvd, Roswell, GA 30076-4915 Ph: (770) 751-2500 | Amira Boulos Fanous-paul, MD 3000 Hospital Blvd, Roswell, GA 30076 Ph: (770) 751-2500 |
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