Susan Marie Boutte, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

694782 Issued in TX

Practice address

1400 Holcombe Blvd
Unit 442
Houston, TX 77030-4008

Phone

(713) 792-1942

Fax

(713) 794-4950

NPI assigned

Jul 28, 2009

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

Other names 1

• Susan Marie Broussard Former name

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2009

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Physicians Referral ServiceGroup PAC ID 7911801410, 2,728 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• University of Texas M D Anderson Cancer Center Hospital, Houston, TX, CCN 450076

Merit-based Incentive Payment System (MIPS)

Final score

84.29 of 100Reported as group

Quality

70.82

Promoting interoperability

100

Improvement activities

40

Cost

67.65

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: sboutte11317@utmdandersoncc.direct-ci.com

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.

• Physicians Referral Service

  • Multi-Specialty Clinic/Center
  • Houston, TX
  • NPI 1073574810
  Medicare reassignment Care Compare group NPD
• Texas Children'S Physician Group

  • Pediatrics Physician
  • Houston, TX
  • NPI 1861675506
  Medicare reassignment NPD
• Sadler Clinic Association

  • Multi-Specialty Clinic/Center
  • Conroe, TX
  • NPI 1114979127
  NPD (past)

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

• University of Texas M. D. Anderson Cancer Center

  • General Acute Care Hospital
  • Houston, TX
  • NPI 1174582050
  Care Compare affiliation

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

{
    "created_epoch": "1248739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338854400000",
    "number": "1457582272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 HOLCOMBE BLVD",
            "address_2": "UNIT 442",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304008",
            "telephone_number": "713-792-1942",
            "fax_number": "713-794-4950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1400 HOLCOMBE BLVD",
            "address_2": "UNIT 442",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304008",
            "telephone_number": "713-792-1942",
            "fax_number": "713-794-4950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTTE",
        "first_name": "SUSAN",
        "middle_name": "MARIE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-28",
        "last_updated": "2012-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "694782",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP MEDICARE",
            "identifier": "00J21A",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SUSAN",
            "last_name": "BROUSSARD",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Mina Boutrous, M.D.
• Caleb James Boutte
• Dykie Boutte
• Parys Seymonne Boutte, FNP-C
• Patrina Boutte, CRNA
• Tiffanie Boutte, NP-C
• Preston Walker Bouwhuis
• Savanna Malki Bouz, RD
• Aurelio Emilio Bovell I
• Bovering Healthcare Services

• Family Nurse Practitioner in Houston, TX
• Providers in Houston, TX by specialty
• Family Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2012; 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.