Fritz Boutin, MD

Primary specialty

General Practice PhysicianTaxonomy code 208D00000X

License

132932 Issued in NY

Practice address

485 Throop Ave
3Rd Floor
Brooklyn, NY 11212

Phone

(718) 574-2462

NPI assigned

Aug 31, 2006

Sex

Male

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 3

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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.

• City of New York Office of Payroll Administration

  dba New York City Dept of Health & Mental Hygiene Richmond

  • Community Health Clinic/Center
  • Staten Island, NY
  • NPI 1366499444
  NPD (past)
• City of New York Office of Payroll Administration

  dba New York City Department of Health & Mental Hygienes Manhattanville H

  • Community Health Clinic/Center
  • New York, NY
  • NPI 1659327674
  NPD (past)
• Eddy J. Vincent Physician,P.C.

  • Specialist
  • Brooklyn, NY
  • NPI 1366989790
  NPD (past)
• Tri-State Foot Care, P.C

  • Podiatrist
  • Brooklyn, NY
  • NPI 1972762458
  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1326150475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 74",
            "address_2": "125 WORTH ST RM 901",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100134006",
            "telephone_number": "212-442-8468",
            "fax_number": "212-442-8452"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "485 THROOP AVE",
            "address_2": "3RD FLOOR",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "11212",
            "telephone_number": "718-574-2462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTIN",
        "first_name": "FRITZ",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-31",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "NY",
            "license": "132932",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPIRE",
            "identifier": "05A94",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0105AH",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "0105AI",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eden Tamar Bouskila
• Joseph Bouskila
• Muhammad Fouad Bouso, MD
• Janelle Bousquet, MA
• Idan Boussani, DO
• Nadine Boutin
• Rose Boutin, RN
• Majdeline Boutros, RPH
• Sabrina Boutros, PA-C
• Samir Samuel Boutros, MD

• General Practice Physician in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• General Practice Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.