Dr John William Bouldin, MD in Salem, VA

Dr John William Bouldin, MD is a medicare enrolled "Pediatrics" physician in Salem, Virginia. His current practice location is 1802 Braeburn Dr, Salem, Virginia. You can reach out to his office (for appointments etc.) via phone at (540) 772-3580.

Dr John William Bouldin is licensed to practice in Virginia (license number 0101055716) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1386624930.

Contact Information

	Dr John William Bouldin, MD
	1802 Braeburn Dr, Salem, VA 24153-7357
	(540) 772-3580
	(540) 725-5012

Map and Direction

Physician's Profile

Full Name	Dr John William Bouldin
Gender	Male
Speciality	Pediatrics
Location	1802 Braeburn Dr, Salem, Virginia
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1386624930
Provider Enumeration Date: 01/19/2006
Last Update Date: 05/02/2011

Medicare PECOS Information:

PECOS PAC ID: 6002999869
Enrollment ID: I20110419000586

Medical Identifiers

Medical identifiers for Dr John William Bouldin such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1386624930	NPI	-	NPPES
6701302	Medicaid	VA
281202	Other	VA	AMERIGROUP
1386624930	Medicaid	VA

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
208000000X	Pediatrics	0101055716 (Virginia)	Primary

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 John William Bouldin allows following entities to bill medicare on his behalf.

Entity Name	Lewis Gale Physicians Llc
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1902977705 PECOS PAC ID: 6507886231 Enrollment ID: O20051128000164

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 John William Bouldin 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 John William Bouldin, MD 1802 Braeburn Dr, Salem, VA 24153-7357 Ph: (540) 772-3580	Dr John William Bouldin, MD 1802 Braeburn Dr, Salem, VA 24153-7357 Ph: (540) 772-3580

Reviews and Comments

Pediatrics Doctors in Salem, VA

Mr. William Christopher Thomsen Jr., Pediatrics Medicare: Accepting Medicare Assignments Practice Location: 1641 Millwood Dr, Salem, VA 24153 Phone: 434-907-3296
Dr. Russell Delaney, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1802 Braeburn Dr, Salem, VA 24153 Phone: 540-772-3580 Fax: 540-725-5012
Mohammed Abdul Khadar Siddiqui, DO Pediatrics Medicare: Medicare Enrolled Practice Location: 1802 Braeburn Dr, Salem, VA 24153 Phone: 540-772-3580 Fax: 540-725-5012
Dr. Lauren Good, D.O. Pediatrics Medicare: Medicare Enrolled Practice Location: 1802 Braeburn Dr, Salem, VA 24153 Phone: 540-772-3580 Fax: 540-725-5012
Dr. Robert Payne, MD Pediatrics Medicare: Not Enrolled in Medicare Practice Location: 1802 Braeburn Dr, Salem, VA 24153 Phone: 540-772-3580 Fax: 540-725-5012
Dr. Joyce Cummings, M.D. Pediatrics Medicare: Medicare Enrolled Practice Location: 1802 Braeburn Dr, Salem, VA 24153 Phone: 540-772-3580 Fax: 540-725-5012

Dr John William Bouldin, MD - Medicare Pediatrics in Salem, VA