- Practice location
- 2353 Hughes Ave, Apt 1A, Bronx, NY 10458-8267
- Phone
- 646-737-4364
- Fax
- —
- Last updated
- May 18, 2026
Jason Peter Boulware is an Emergency Medicine based in Bronx, NY. Jason Peter Boulware practices in Bronx, NY and has the professional credentials of DO. The NPI Number for Jason Peter Boulware is 1013211168 and holds a License No. 25MB09297500 (NJ). The current practice location address for Jason Peter Boulware is 2353 Hughes Ave, Apt 1A, Bronx, NY 10458-8267 and can be reached out via phone at 646-737-4364.
Provider Profile Details
- NPI Number
- 1013211168
- Provider Name
- Jason Peter Boulware
- Credential
- DO
- Provider Entity Type
- Individual
- Gender
- Male
- Address
- 2353 Hughes Ave, Apt 1A, Bronx, NY 10458-8267
- Phone Number
- 646-737-4364
- Primary Taxonomy
- Emergency Medicine · 207P00000X
- Sole Proprietor
- No
- Provider Enumeration Date
- January 4, 2011
- Last Update Date
- May 18, 2026
- Certification Date
- May 18, 2026
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 2353 Hughes Ave
Apt 1A
Bronx, NY 10458-8267 - City
- Bronx
- State
- New York
- Zip
- 10458-8267
- Phone Number
- 646-737-4364
Provider Business Mailing Address Details
- Address
- 515 Valley St Ste 203
Maplewood, NJ 07040-4300 - City
- Maplewood
- State
- NJ
- Zip
- 07040-4300
- Phone Number
- 908-663-2929
License Information
- License Number (1)
- 25MB09297500
- License State (1)
- NJ
- Taxonomy (1)
- Emergency Medicine · 207P00000X
- License Number (2)
- 259532-1
- License State (2)
- NY
- Taxonomy (2)
- Emergency Medicine · 207P00000X · Primary
- License Number (3)
- DO00706
- License State (3)
- RI
- Taxonomy (3)
- Emergency Medicine · 207P00000X
- License Number (4)
- 286222
- License State (4)
- MA
- Taxonomy (4)
- Emergency Medicine · 207P00000X
- License Number (5)
- 24237
- License State (5)
- CA
- Taxonomy (5)
- Emergency Medicine · 207P00000X
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
Other Emergency Medicine providers near Bronx, NY
View all Emergency Medicine providers in Bronx →Frequently Asked Questions
What is the NPI number of Jason P Boulware, DO?
The NPI number of Jason P Boulware, DO is 1013211168. It was assigned on January 4, 2011 and is currently active in the NPPES registry.
What is the specialty of Jason P Boulware, DO?
Jason P Boulware, DO is registered under the primary taxonomy Emergency Medicine (code 207P00000X), licensed in NJ under license number 25MB09297500.
Where does Jason P Boulware, DO practice?
The practice location is 2353 Hughes Ave, Apt 1A, Bronx, NY 10458-8267. The office can be reached at 646-737-4364 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1013211168 directly on the NPPES registry website.