Shady Boules, NP
NPI 1497123517 · Psychiatric/Mental Health Nurse Practitioner · Riverside, CA
Enrolled with Medicare as Practitioner - Nurse Practitioner · source: CMS PECOS Public Provider Enrollment (2026.04.01)
Shady Boules, NP is a Psychiatric/Mental Health Nurse Practitioner provider in Riverside, CA (NPI 1497123517).
Provider details
- NPI number
- 1497123517
- Entity type
- Individual
- Primary specialty
- Psychiatric/Mental Health Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- NP
- Sex
- Male
- Sole proprietor
- Yes
- License
- 95037846 (CA)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
2 documented practice locations
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Additional practice locations (1)
- 4695 Macarthur Ct Ste 1100Newport Beach, CA 92660-1866Phone: (949) 293-3440
Registry dates
- Enumerated
- 2015-09-04
- Last updated
- 2025-12-25
- Certified
- 2025-12-25
Frequently asked questions
- What is Shady Boules's NPI number?
- Shady Boules's National Provider Identifier (NPI) is 1497123517, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What is Shady Boules's specialty?
- Shady Boules is listed in the NPPES registry with a primary specialty of Psychiatric/Mental Health Nurse Practitioner (Physician Assistants & Advanced Practice Nursing Providers).
- Where is Shady Boules located?
- Shady Boules's practice location on file with NPPES is 16282 Skyridge Dr, Riverside, CA 92503-0562.
- What is Shady Boules's phone number?
- The practice phone number listed in the NPPES registry for Shady Boules is (951) 722-0802.
- Does Shady Boules accept Medicare?
- Shady Boules is approved to bill Medicare according to CMS PECOS enrollment data (2026.04.01). Confirm current participation with the provider before scheduling.
- Is Shady Boules's NPI active?
- Yes — Shady Boules's NPI (1497123517) is active in the NPPES registry as of the last update on 2025-12-25.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.