Mounir Boutros MD Inc

Primary specialty

SpecialistTaxonomy code 174400000X

License

35062133B Issued in OH

Legal business name

MOUNIR BOUTROS MD INC

Practice address

5951 Renaissance PL
Toledo, OH 43623-4722

Phone

(419) 824-2288

Fax

(419) 824-2287

NPI assigned

Jul 6, 2006

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mounir Boutros, MDNPI 1235105941

Title

Owner

Phone

(419) 824-2288

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Mounir Boutros, MD

  • Dermatology Physician
  • Toledo, OH
  • NPI 1235105941
  Medicare reassignment Care Compare group NPD Authorized official
• Amy Jo Hennessy

  • Physician Assistant
  • Toledo, OH
  • NPI 1629403134
  Medicare reassignment Care Compare group
• Megan Marie Peck

  • Physician Assistant
  • Columbus, OH
  • NPI 1639340458
  Medicare reassignment
• Nina N. Rettig, PA-C

  • Physician Assistant
  • Toledo, OH
  • NPI 1609971399
  Medicare reassignment

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

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1437181203",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5951 RENAISSANCE PL",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234722",
            "telephone_number": "419-824-2288",
            "fax_number": "419-824-2287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5951 RENAISSANCE PL",
            "city": "TOLEDO",
            "state": "OH",
            "postal_code": "436234722",
            "telephone_number": "419-824-2288",
            "fax_number": "419-824-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNIR BOUTROS MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BOUTROS",
        "authorized_official_first_name": "MOUNIR",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "419-824-2288",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "OH",
            "license": "35062133B",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jiaron Keith Mothershed
• Shannon Mothershed
• Lakshya Motwani, M.D.
• Kelly Erin Motz, NNP
• Varsha Vivek Moudgal, MD
• Brandon D Mount, MD
• Jason Mount
• Kelly Lynn Mounts, LPN
• Imad K Mourad, PHARMACIST
• Yousof H Mousa, MD

• Specialist in Toledo, OH
• Providers in Toledo, OH by specialty
• Specialist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.