Jacqueline Anne Boulris, PA-C
NPI 1639937154ActiveIndividual· Physician Assistant, Medical· Reston, VA
Physician Assistant, Medical (PA-C) in Reston, Virginia, licensed in VA, with an NPI issued in March 2024. Enrolled in Medicare as practitioner - physician assistant. Dexcom, Inc. was the largest of 2 companies reporting payments in 2025, $41.82 in all, mostly food and beverage.
Overview
| NPI | 1639937154 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PA-C |
| Sole proprietor | No |
| NPI issued | Mar 11, 2024 |
| Last updated in NPPES | Feb 21, 2025 |
| Certified by provider | Feb 21, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physician Assistant, Medical Primary | 363AM0700X | 0110009803 | VA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physician Assistant (DC) |
|---|
Education and affiliations
| Graduation year | 2023 |
|---|---|
| Medicare specialty | Physician Assistant |
Industry payments (Open Payments)
- 2025$41.82 · 2 payments from 2 companies
- 2024$51.57 · 2 payments from 2 companies
Top paying companies in 2025
| Company | Amount | Payments |
|---|---|---|
| Dexcom, Inc. | $28.00 | 1 |
| Mayne Pharma Commercial LLC | $13.82 | 1 |
What the 2025 payments were for
- Food and Beverage$41.82 · 2 payments
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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