Amanda Boulos
Surgical Physician Assistant · Marietta, GA
Amanda Boulos is a surgical physician assistant with a practice address in Marietta, Georgia, and NPI 1194503722, issued on Sep 15, 2023. Check the license (Georgia 12976, as entered in NPPES) with the Georgia board that licenses this profession; the Medicare figures below come from public CMS files.
- Name
- Amanda Boulos
- Primary taxonomy
- Surgical Physician Assistant 363AS0400X
- License number
- 12976 GA
Self-reported in NPPES; status is on the state search - Practice location
- 1371 Church Street Ext NE, Marietta, GA 30060
- Phone
- (678) 481-0579
- Enumerated
- Sep 15, 2023
- Record last updated
- Apr 28, 2025
- Medicare enrollment
- Enrolled (PECOS I20250314002737); accepts Medicare assignment
- Entity
- Type 1 · individual
8 nearest surgical physician assistant records → All 531 in Georgia → Look up another NPI →
Also registered at 1371 Church Street Ext NE
A shared address usually means a shared clinic or building; it does not show who employs whom.
- Jason Lomboy, M.D.Urology Physician1265843312
- Andrew Ostrowski, M.D.Urology Physician1831505361
Verify Amanda Boulos in five checks
- 1IdentityNPI record in CMS NPPESNPI lookupConfirmed in NPPES
- 2LicenseActive license and public ordersWhich Georgia board licenses this profession
Search for license 12976Check the board - 3Other statesLicenses and actions elsewhereDocInfo (FSMB)Not checked
- 4ExclusionsMedicare and Medicaid bansHHS-OIG exclusion listNot checked
- 5CertificationBoard certificationABMS AOA NCCPA AANPNot checked
Bills Medicare through one group practice
- Advanced Urology Institute OF GeorgiaMarietta, GA
Source: CMS Doctors and Clinicians National Downloadable File (the group practices a clinician bills Medicare through) (data.cms.gov).
Amanda Boulos among 531 surgical physician assistant records in Georgia
Amanda Boulos is one of 531 surgical physician assistant records with a practice address in Georgia. 63% of them appear in a Medicare file (Part D prescribing, MIPS, Open Payments or Medicare group billing); this one does. Its NPI, issued in 2023, is newer than 89% of them.
- NPI issued2023 · 89% of these records are older, 6% newer
- In a Medicare fileYes · 63% of these records are
- In the CMS Doctors and Clinicians fileYes · 52% of these records are
- Graduated2024 · median 2014 among the 276 with a school on file
- Record last updated2025 · 55% of these records were not updated in five years or more
Source: CMS NPPES, file of Aug 9, 2026, every record with primary taxonomy 363AS0400X and a Georgia practice address; Medicare files: CMS Part D Prescribers 2024, MIPS 2023, Open Payments 2024, Doctors and Clinicians (data.cms.gov).
Surgical Physician Assistant providers in Georgia
There are 531 surgical physician assistant records in Georgia.
All 531 in Georgia → Every provider in Marietta → Surgical Physician Assistant nationwide →
The 8 surgical physician assistant records with the nearest ZIP codes
- Derek Baker, PA-CMarietta, GA 300601427300193
- Allison Berard, PA-CMarietta, GA 300601659694867
- Paula Cutrona, PA-CMarietta, GA 300601083765937
- Angela Dimare, PA-CMarietta, GA 300601245483486
- Loren Halbrooks, PA-CMarietta, GA 300601780008995
- Deleen Huff, PA-CMarietta, GA 300601962648501
- Brandon King, CSA, CSFAMarietta, GA 300601033447313
- Jeremy Melton, PA-CMarietta, GA 300601902213853
Common questions
What is Amanda Boulos's NPI number?
Amanda Boulos's National Provider Identifier (NPI) is 1194503722, issued on Sep 15, 2023. An NPI identifies a provider in billing; it is not a license.
Where is Amanda Boulos located?
The NPPES record lists a practice address at 1371 Church Street Ext NE, Marietta, GA, 30060. Phone: (678) 481-0579. Providers update this record themselves, so call before visiting.
How can I verify Amanda Boulos's license?
NPPES lists Georgia license number 12976, as entered by the provider. Search the Georgia board that licenses this profession; the NPPES record confirms identity only.
Source: CMS National Plan and Provider Enumeration System (NPPES), file of Aug 9, 2026 (NPPES files on CMS.gov); NUCC Health Care Provider Taxonomy. Medicare files from data.cms.gov. An NPI identifies who bills; it is not a license.
Figures on PlainDoctor are read from the federal files each page names (CMS NPPES, Medicare Part D, MIPS, Open Payments; the HHS-OIG exclusion list only as counts) and from Census population estimates, with the file date shown beside them. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error. Data current as of Aug 9, 2026.