Independent US Healthcare Provider Directory & Public Medical Database
Deactivated NPI 1518165463 Deactivated / Inactive NPI Male Practitioner

Dr. George P Boolukos , MD

Voluntary or Charitable • Plattsburgh, NY

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. George Boolukos has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date July 03, 2007
NPI Deactivation Date April 16, 2018
Total Practice Duration ~11 Years of Practice (2007 – 2018)

Professional Overview & Biography Verified Profile Summary

Dr. George Boolukos, MD was a registered Voluntary or Charitable practicing in Plattsburgh, NY. Throughout an active medical career spanning 11 years, Dr. Boolukos provided care at the practice location at 210 CORNELIA ST until profile deactivation on 2018-04-16.

Practice Location & Contact Primary Location

Practice Address

210 Cornelia St
Suite 105

Plattsburgh, NY 129012318

Telephone 5185633700
Fax 5185633739
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Voluntary or Charitable in Plattsburgh, NY

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 36.0 Yrs
Regional Practice Density
1 Specialists

Practicing in Plattsburgh, NY (8 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Voluntary or Charitable Primary Specialty

NUCC Taxonomy Code: 251V00000X

State License NY 076054

Definition to come...

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

13 Associated Practitioners
Deborah Kampschror , PA

Physician Assistant - Medical

NPI 1013141860

Physician Assistant

Kevin Greene , OPTICIAN

Technician/Technologist - Optician

NPI 1013293257
NPI 1205934940

Doctor of Medicine (M.D.)

Karen Grunewald , APRN

Nurse Practitioner - Adult Health

NPI 1306899257

Advanced Practice Registered Nurse

Dr. Timothy Garrand , MD

Internal Medicine - Cardiovascular Disease

NPI 1326041989

Doctor of Medicine (M.D.)

Carla Hausrath , RN, NP

Nurse Practitioner - Adult Health

NPI 1508095399

Registered Nurse, Nurse Practitioner

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 16, 2018

Record deactivated on April 16, 2018

NPI Profile Active July 08, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 08, 2007

Registered at 210 CORNELIA ST, SUITE 105, PLATTSBURGH, NY 129012318 (Tel: 5185633700)

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Updated Business Mailing Address July 08, 2007

Registered at 1 KENT LN, PLATTSBURGH, NY 129011816 (Tel: 5185637492)

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Provider Name / Credentials Updated July 08, 2007

Recorded as GEORGE BOOLUKOS, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 08, 2007

Voluntary or Charitable (License #076054 in NY)

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Initial NPI Registration & Enumeration July 03, 2007

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1518165463
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: July 03, 2007
Last Update: July 08, 2007
Deactivation Date: April 16, 2018

Mailing Address

1 Kent Ln

Plattsburgh, NY 129011816

Phone: 5185637492

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.