Dr Sophia Boulukos, MD is a medicare enrolled "Internal Medicine" physician in Sayville, New York. She graduated from medical school in 2004 and has 20 years of diverse experience with area of expertise as Internal Medicine. She is a member of the group practice Physicians Private Practice Pllc and her current practice location is
160 Middle Rd, Sayville, New York. You can reach out to her office (for appointments etc.) via phone at
(631) 379-6728.
Dr Sophia Boulukos is licensed to practice in New York (license number 250691) 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 1922259878.
Physician's Profile
| Full Name | Dr Sophia Boulukos |
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| Gender | Female |
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| Speciality | Internal Medicine |
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| Experience | 20 Years |
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| Location | 160 Middle Rd, Sayville, New York |
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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. |
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Medical Education and Training:
- Dr Sophia Boulukos graduated from medical school in 2004
NPI Data:
- NPI Number: 1922259878
- Provider Enumeration Date: 10/08/2008
- Last Update Date: 10/08/2008
Medicare PECOS Information:
- PECOS PAC ID: 8921139635
- Enrollment ID: I20100624000356
Medical Identifiers
Medical identifiers for Dr Sophia Boulukos such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1922259878 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207R00000X | Internal Medicine | 250691 (New York) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Physicians Private Practice Pllc | 9436274776 | 2 |
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 Sophia Boulukos allows following entities to bill medicare on her behalf.
| Entity Name | Physicians Private Practice Pllc |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1730408923
PECOS PAC ID: 9436274776
Enrollment ID: O20100910000182 |
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| Entity Name | Vytaliz Medical |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1568831105
PECOS PAC ID: 7719296938
Enrollment ID: O20151028002361 |
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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. Dr Sophia Boulukos 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 |
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Dr Sophia Boulukos, MD
262 Helm Ln,
Bay Shore, NY 11706-8109
Ph: (631) 258-9362 | Dr Sophia Boulukos, MD
160 Middle Rd,
Sayville, NY 11782-3126
Ph: (631) 379-6728 |
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