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DR. JASON K BOUTROS M.D. NPI 1942243563


NPI Information

NPI: 1942243563
Provider Name: DR. JASON K BOUTROS, M.D.
Classification: Specialist - 174400000X
Entity Type: Individual

PECOS Registration: Yes

CLIA Number: 05D0906600

Address:
2554 E WASHINGTON BLVD
STE A
PASADENA, CA
ZIP 91107
Phone: (626) 798-8923
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DR. Jason K Boutros, M.D. is a specialist in Pasadena, CA with 41 years of experience. The provider is an individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. DR. Jason K Boutros, M.D. NPI is 1942243563. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2554 E WASHINGTON BLVD
STE A
PASADENA, CA
ZIP 91107-445
Phone: (626) 798-8923
Fax: (626) 798-0258

The NPI 1942243563 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The CLIA number assigned to this NPI record is 05D0906600 - physician office with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Injection beneath the skin or into muscle for therapy, diagnosis, or prevention (HCPCS:96372)
  • Physician certification for medicare-covered home health services under a home health plan of care (patient not present), including contacts with home health agency and review of reports of patient status required by physicians to affirm the initial implem (HCPCS:G0180)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
  • Urinalysis, manual test (HCPCS:81002)
  • Routine ekg using at least 12 leads including interpretation and report (HCPCS:93000)
  • Removal of impact ear wax, one ear (HCPCS:69210)

The enumeration date for this NPI number is 6/13/2006 and was last updated on 2/2/2017.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1174400000XSpecialistA42891CALIFORNIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1WA42891CMEDICARE PINCALIFORNIA
2WA42891DMEDICARE PINCALIFORNIA
300A42891MEDICAIDCALIFORNIA
4A42891OTHERCALIFORNIALICENSE NO.
5C04014MEDICARE UPINCALIFORNIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.