Nader Gamil Boutros, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A180657 Issued in CA

Practice address

4445 Magnolia Ave., Gme Office
Riverside, CA 92501-4135

Phone

(951) 788-3000

NPI assigned

Mar 16, 2019

Last updated

Aug 3, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

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: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

PsychiatryAlso: Neurology

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Vascular Neurology of Southern California IncGroup PAC ID 0143558643, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• UCLA West Valley Medical Center Hospital, West Hills, CA, CCN 050481
• Los Robles Hospital & Medical Center Hospital, Thousand Oaks, CA, CCN 050549
• Ronald Reagan UCLA Medical Center Hospital, Los Angeles, CA, CCN 050262

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nader.boutros@200733209001988.direct.elationemr.com
• Direct secure messaging: nboutros1156783@direct.uclahealth.org

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

• Vascular Neurology of Southern California Inc

  • Vascular & Interventional Radiology Physician
  • Thousand Oaks, CA
  • NPI 1326609124
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Los Robles Regional Medical Center

  dba Los Robles Hospital & Medical Center

  • General Acute Care Hospital
  • Thousand Oaks, CA
  • NPI 1306890389
  Care Compare affiliation
• Regents Univ of Calif Los Angeles

  dba UCLA West Valley Medical Center

  • General Acute Care Hospital
  • West Hills, CA
  • NPI 1801653969
  Care Compare affiliation
• Regents Univ of Calif Los Angeles

  dba Ronald Reagan UCLA Medical Center

  • General Acute Care Hospital
  • Los Angeles, CA
  • NPI 1902803315
  Care Compare affiliation

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

{
    "created_epoch": "1552694400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1376002683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE., GME OFFICE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014135"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 MAGNOLIA AVE., GME OFFICE",
            "city": "RIVERSIDE",
            "state": "CA",
            "postal_code": "925014135",
            "telephone_number": "951-788-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTROS",
        "first_name": "NADER",
        "middle_name": "GAMIL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-03-16",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "A180657",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A180657",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Delana Bouldin
• Shady Boules, NP
• Tiffaney Boulware, MFTI
• Jonah D Bourbinay
• Claudia Bouslough, M.S., M.A., LMFT
• Lisa Bouzaglou
• Amber Elaine Bowen
• Sarah Bower
• John Lawrence Bowers, MFT
• Laura Bowers

• Neurology Physician in Riverside, CA
• Providers in Riverside, CA by specialty
• Neurology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; 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.