LUIS L BOULART – Family Nurse Practitioner, NPI 1225639180

LUIS L BOULART is a healthcare provider. based in Medley, Florida. specializing in NURSE PRACTITIONER. They hold a License No. APRN11008799 (FL). The NPI Number for LUIS L BOULART is 1225639180

Main info

Male
8 Years Of Experience
Accepts Medicare Assignment
Name
LUIS L BOULART
NPI
1225639180
Phone
(954) 514-9360
Address
9725 NW 117th Ave Ste 200
Enumeration Date
5 November 2020
Last Update Date
27 December 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8663471821
Graduation Year
2018 (8 years ago)
PAC ID
8729249032
Group Practice PAC ID
8426436742
Professional Enrollment ID
I20210126000606
Address ID
FL331442069MI8260XSTXX425
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:5State licenses:1Digital endpointsOther names

24,243 NURSE PRACTITIONER in FL

Provider Addresses for LUIS L BOULART

  • 9725 NW 117th Ave Ste 200

    Medley, FL 331781260

    Phone: (954) 514-9360

    Type: Location

  • 9725 NW 117TH AVE STE 200

    MEDLEY, FL 331781260

    Phone: (954) 514-9360

    Type: Location

  • 8260 W FLAGLER ST STE 2I

    MIAMI, FL 331442069

    Phone: (786) 715-9183

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-01-26

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210126000606INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99347Residence visit for established patient with straightforward medical decision making, per day, if using time, at least 15 minutes1813$0
View full utilization report →

Insurance plans in this area (ZIP 33178)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 8426436742View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Family PracticeFL
Internal MedicineFL
Internal MedicineFL
Internal MedicineFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

How do payers reference LUIS L BOULART?
For LUIS L BOULART, use NPI 1225639180 as the unique 10-digit identifier.
Active or inactive — what applies to LUIS L BOULART?
You should see LUIS L BOULART as active in CMS-hosted NPPES data.
What expertise is attributed to LUIS L BOULART?
LUIS L BOULART's specialty line reads Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
Where in Florida is LUIS L BOULART registered?
Use Medley, Florida as the headline location for LUIS L BOULART here.
Does LUIS L BOULART accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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