Individual provider Active NPI

Harold Joseph Boutte Jr., M.D.

  • Gastroenterology Physician
  • Chicago, IL
National Provider Identifier
1487911038
Registry record updated Apr 18, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
036145207 Issued in IL
Practice address
259 E Erie St Ste 1600
Chicago, IL 60611-3111
Phone
(312) 695-5620
NPI assigned
Apr 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 036145207 IL Primary

Addresses

Primary practice location

259 E Erie St Ste 1600
Chicago, IL 60611-3111

Mailing address

259 E Erie St Ste 1600
Chicago, IL 60611-3111
Phone (312) 695-5620

Other practice location 1

676 N Saint Clair St Ste 1400
Chicago, IL 60611-2951
Phone (312) 695-5398

Other names 1

  • Dr. Hal Jospeh Boutte Jr. Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20180523000233 IL Practitioner - GastroenterologyPractitioner - Internal Medicine 5496010431 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
GastroenterologyAlso: Internal Medicine
Education
Duke University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northwestern Medical Faculty FoundationGroup PAC ID 4587576814, 4,386 clinicians

Practice addresses (Care Compare)

259 E Erie St
Chicago, IL 60611-2930
Phone (312) 503-1944

Hospital & facility affiliations

  • Northwestern Memorial Hospital Hospital, Chicago, IL, CCN 140281
  • Palos Community Hospital Hospital, Palos Heights, IL, CCN 140062
  • Northwestern Lake Forest Hospital Hospital, Lake Forest, IL, CCN 140130
  • Northwestern Medicine Central Dupage Hospital Hospital, Winfield, IL, CCN 140242

Merit-based Incentive Payment System (MIPS)

Final score
95.19 of 100Reported as apm
Quality
83.05
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy25
Upper gastrointestinal (GI) endoscopy for acid reflux24

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
036145207ILMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2018 Accepting new patients
Northwestern Medical Faculty Foundation CurrentSince Jul 1, 2018 Accepting new patients
Central Dupage Physician Group Past Accepting new patients

Locations

Dept 5777
Carol Stream, IL 60122

Carol Stream, IL 60122
Phone (630) 933-3300

680 N Lake Shore Dr
Ste 1000
Chicago, IL 60611
Phone (312) 695-4022

676 N Saint Clair St
Ste 1400
Chicago, IL 60611
Phone (312) 695-1292

259 E Erie St
Ste 1600
Chicago, IL 60611

259 E Erie St
Chicago, IL 60611

660 N Westmoreland Rd
#302
Lake Forest, IL 60045

Organizations & group practices 3

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.

Hospital & facility affiliations 6

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

NPI Registry JSON

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

{
    "created_epoch": "1334880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1524009600000",
    "number": "1487911038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 1600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113111",
            "telephone_number": "312-695-5620"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 E ERIE ST STE 1600",
            "city": "CHICAGO",
            "state": "IL",
            "postal_code": "606113111",
            "telephone_number": "312-695-5620"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "676 N Saint Clair St Ste 1400",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112951",
            "country_code": "US",
            "telephone_number": "312-695-5398",
            "fax_number": "312-695-3999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUTTE",
        "first_name": "HAROLD",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-20",
        "last_updated": "2018-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "IL",
            "license": "036145207",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "HAL",
            "last_name": "BOUTTE",
            "middle_name": "JOSPEH",
            "prefix": "DR.",
            "suffix": "JR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Chicago, IL

Sources for this page

Verify at the official NPI Registry.