Lourice Boutros, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

33939TLG Issued in CA

Practice address

3235 E Colorado Blvd Ste 101
Pasadena, CA 91107

Phone

(626) 765-6634

NPI assigned

Jun 22, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Southern California College of Optometry, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• See Clear Optometry a Professional Corporation

  • Optometrist
  • Pasadena, CA
  • NPI 1679117196
  Medicare reassignment NPD Authorized official
• Dr. Arlene T. Yepremian, O.D. a Professional Corporation

  • Clinic/Center
  • Glendale, CA
  • NPI 1043547482

  Optometrist

  NPD (past)
• Linden Optometry a Professional Corporation

  • Optometrist
  • Pasadena, CA
  • NPI 1831201078
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1529625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1572307200000",
    "number": "1083109904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3235 E COLORADO BLVD STE 101",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "911073837",
            "telephone_number": "626-765-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3235 E COLORADO BLVD STE 101",
            "city": "PASADENA",
            "state": "CA",
            "postal_code": "91107",
            "telephone_number": "626-765-6634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2771 Rowena Ave",
            "address_purpose": "LOCATION",
            "city": "Los Angeles",
            "state": "CA",
            "postal_code": "900392720",
            "country_code": "US",
            "telephone_number": "323-664-1996",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "477 E Colorado Blvd",
            "address_purpose": "LOCATION",
            "city": "Pasadena",
            "state": "CA",
            "postal_code": "911012024",
            "country_code": "US",
            "telephone_number": "626-588-2020",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUTROS",
        "first_name": "LOURICE",
        "name_prefix": "Miss",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-22",
        "last_updated": "2019-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "CA",
            "license": "33939TLG",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NONE",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "seeclearoptometry@gmail.com",
            "affiliation": "N",
            "address_1": "3235 E Colorado Blvd Ste 101",
            "city": "Pasadena",
            "state": "CA",
            "country_code": "US",
            "postal_code": "911073837",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Bourne Inc
• Bourne Inc
• Christopher Andre Bourne
• Charriel Marie Bourns
• Jason K Boutros, M.D.
• Vasag H Bouzoghlanian, D.D.S.
• Michael Bowen Dural
• Imani Laraine Bowers
• Harry Fisk Bowles, M.D.
• Dusty Dawn Bowman, RDHAP

• Optometrist in Pasadena, CA
• Providers in Pasadena, CA by specialty
• Optometrist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.