CHRISTINA LEE BOULL (MD) – Pediatric Dermatology Physician, NPI 1225222862
Pediatric Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
717 PEDIATRIC MEDICINE in MN
Provider Addresses for CHRISTINA LEE BOULL (MD)
715 S 8th St
Minneapolis, MN 554041210
Phone: (612) 873-6963
Type: Location
Washington Avenue Southeast, Prospect Park - East River Road, Minneapolis, Hennepin County, Minnesota, 55414, United States
MINNEAPOLIS, MN 554142924
Phone: (651) 884-0749
Type: Mailing
Bambini's Coffee, 2450, Riverside Avenue, Phillips, Minneapolis, Hennepin County, Minnesota, 55454, United States
MINNEAPOLIS, MN 554541450
Phone: (612) 365-6777
Fax: (612) 365-4370
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 1 Open Payments records for all available years, with a total value of $3,840.
Total Amount is formed as General ($3,840) + Research ($0) + Ownership ($0) = $3,840.
Last reported payment date: 2023-02-08 • Largest payer in this snapshot: Alexion Pharmaceuticals, Inc. ($3,840).
Total Amount
$3,840
General + Research + Ownership
Payments
1
Total payment records
General Amount
$3,840
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2023-02-08
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Alexion Pharmaceuticals, Inc. | $3,840 |
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: 2015-05-19
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20150519002337 | I | Pediatric Medicine | MN | TBD |
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.
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
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 103 | 16 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 49 | 36 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 40 | 36 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 31 | 24 | $0 |
| 11102 | Biopsy of related skin growth, first growth | 20 | 19 | $0 |
Insurance plans in this area (ZIP 55404)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P A T H O L O G Y | MN | |
| G A S T R O E N T E R O L O G Y | MN | |
| N E U R O S U R G E R Y | OH | |
| - | MN | |
| Physician Assistant | MN | |
| Physician Assistant | MN | |
| - | MN | |
| - | MN | |
| Physical Therapist In Private Practice | OR | |
| Cardiovascular Disease (Cardiology) | IL |
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