Samir Samuel Boutros, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

004090 Issued in NY

Practice address

2400 Linden Blvd
Brooklyn, NY 11208-4830

Phone

(718) 257-5800

Fax

(718) 649-7040

NPI assigned

Jul 11, 2012

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• JHMC Diagnostic and Treatment Center

  • Family Medicine Physician
  • Jamaica, NY
  • NPI 1821045485

  Internal Medicine

  NPD (past)
• TJH Medical Services, P.C.

  • Internal Medicine Physician
  • Jamaica, NY
  • NPI 1184670465
  NPD (past)

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

{
    "created_epoch": "1341964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1341964800000",
    "number": "1245595602",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13935 COOLIDGE AVE",
            "city": "BRIARWOOD",
            "state": "NY",
            "postal_code": "114351118",
            "telephone_number": "718-216-3166",
            "fax_number": "718-649-7040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2400 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112084830",
            "telephone_number": "718-257-5800",
            "fax_number": "718-649-7040"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTROS",
        "first_name": "SAMIR",
        "middle_name": "SAMUEL",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-07-11",
        "last_updated": "2012-07-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "004090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Fritz Boutin, MD
• Nadine Boutin
• Rose Boutin, RN
• Majdeline Boutros, RPH
• Sabrina Boutros, PA-C
• Catherine Boutsikakis, RPH
• Anastasios Boutsis, M.S. SLP
• Danielle Bouyer
• Helen Bouzalas, RD, CDN
• Khalid Bouziri, RPH

• Internal Medicine Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.