Dr Maryana Carole Boulos, MD in Salt Lake City, UT

Dr Maryana Carole Boulos, MD is a medicare enrolled "Family Medicine" physician in Salt Lake City, Utah. Her current practice location is 1250 E 3900 S Ste 260, Salt Lake City, Utah. You can reach out to her office (for appointments etc.) via phone at (801) 265-2000.

Dr Maryana Carole Boulos is licensed to practice in Utah (license number 12851770-1205) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1598325821.

Contact Information

	Dr Maryana Carole Boulos, MD
	1250 E 3900 S Ste 260, Salt Lake City, UT 84124-1371
	(801) 265-2000
	Not Available

Map and Direction

Physician's Profile

Full Name	Dr Maryana Carole Boulos
Gender	Female
Speciality	Family Medicine
Location	1250 E 3900 S Ste 260, Salt Lake City, Utah
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1598325821
Provider Enumeration Date: 06/18/2019
Last Update Date: 11/09/2023

Medicare PECOS Information:

PECOS PAC ID: 3476909938
Enrollment ID: I20231019003596

Medical Identifiers

Medical identifiers for Dr Maryana Carole Boulos such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1598325821	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207Q00000X	Family Medicine	12851770-1205 (Utah)	Primary
207Q00000X	Family Medicine	12851770-1205-1205 (Utah)	Secondary

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. Dr Maryana Carole Boulos allows following entities to bill medicare on her behalf.

Entity Name	Utah Healthcare Institute Inc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1376597344 PECOS PAC ID: 7719882562 Enrollment ID: O20031204000492

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. Dr Maryana Carole Boulos 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
Dr Maryana Carole Boulos, MD 1365 W 1000 N, Salt Lake City, UT 84116-1654 Ph: (801) 328-5750	Dr Maryana Carole Boulos, MD 1250 E 3900 S Ste 260, Salt Lake City, UT 84124-1371 Ph: (801) 265-2000

Reviews and Comments

Family Medicine Doctors in Salt Lake City, UT

Dr. Roy Lewis James, M.D. Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 675 E 2100 S, Suite 390, Salt Lake City, UT 84106 Phone: 800-366-1884 Fax: 801-487-8197
Cynthia M Mathewson, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1525 W 2100 S, Salt Lake City, UT 84119 Phone: 801-887-2400
Peter Thompson Weir, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 555 Foothill Dr, Salt Lake City, UT 84112 Phone: 801-585-5382
Lisa J Hill, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 6556 S Big Cottonwood Canyon Rd Ste 500a, Salt Lake City, UT 84121 Phone: 385-246-1117 Fax: 385-246-1117
Amy Noel De La Garza, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 807 E South Temple Ste 101, Salt Lake City, UT 84102 Phone: 801-369-8989 Fax: 801-704-9741
Dr. Laura M. Yeater, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 375 S Chipeta Way Ste A, Salt Lake City, UT 84108 Phone: 801-587-3411 Fax: 801-581-2771
Wesley J. Lewis, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 6360 S 3000 E, Ste 100, Salt Lake City, UT 84121 Phone: 801-365-1032 Fax: 801-365-1033

Dr Maryana Carole Boulos, MD - Medicare Family Medicine in Salt Lake City, UT