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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NPI Details

DR. Jason K Boutros, M.D. is a specialist in Pasadena, CA with 43 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.

  • Established patient office or other outpatient visit, 30-39 minutes (HCPCS:99214)
  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Follow-up hospital inpatient care per day, typically 25 minutes (HCPCS:99232)
  • Blood glucose (sugar) level (HCPCS:82947)
  • Inhalation treatment for airway obstruction or sputum production (HCPCS:94640)
  • Evaluation of use of breathing device (HCPCS:94664)
  • Critical care, first 30-74 minutes (HCPCS:99291)
  • Insertion of needle into vein for collection of blood sample (HCPCS:36415)
  • Injection of drug or substance under skin or into muscle (HCPCS:96372)
  • Physician or allowed practitioner 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 and (HCPCS:G0180)
  • Injection, dexamethasone sodium phosphate, 1 mg (HCPCS:J1100)
  • Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit (HCPCS:G0439)
  • Injection, vitamin b-12 cyanocobalamin, up to 1000 mcg (HCPCS:J3420)
  • Follow-up hospital inpatient care per day, typically 35 minutes (HCPCS:99233)
  • Annual depression screening, 15 minutes (HCPCS:G0444)
  • Physician or allowed practitioner re-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 a (HCPCS:G0179)
  • Initial hospital inpatient care per day, typically 70 minutes (HCPCS:99223)
  • Urinalysis, manual test (HCPCS:81002)
  • Removal of impacted ear wax (HCPCS:69210)
  • Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report (HCPCS:93000)
  • New patient office or other outpatient visit, 45-59 minutes (HCPCS:99204)
  • Established patient office or other outpatient visit, 10-19 minutes (HCPCS:99212)
  • Follow-up nursing facility visit per day, typically 25 minutes (HCPCS:99309)

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 Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
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 Identifier Other Provider Identifier Type Other Provider Identifier State Other 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: 11/21/2025

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