NPIMap

Individual provider Active NPI

Nihad M Boutros, M.D.

  • Critical Care Medicine (Internal Medicine) Physician
  • Canton, OH
National Provider Identifier
1508869454
Registry record updated Jan 5, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care Medicine (Internal Medicine) PhysicianTaxonomy code 207RC0200X
License
35-065732 Issued in OH
Practice address
2600 Tuscarawas St W
Ste 100
Canton, OH 44708-4696
Phone
(330) 452-8844
Fax
(330) 452-7012
NPI assigned
May 24, 2005
Last updated
Jan 5, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Medicine (Internal Medicine) Physician 207RC0200X 35-065732 OH Primary
Pulmonary Disease Physician 207RP1001X 35-065732 OH
Sleep Medicine (Internal Medicine) Physician 207RS0012X 35-065732 OH

Addresses

Primary practice location

2600 Tuscarawas St W
Ste 100
Canton, OH 44708-4696

Mailing address

2600 Tuscarawas St W
Ste 100
Canton, OH 44708-4696
Phone (330) 452-8844

Other identifiers 7

IdentifierTypeStateIssuer
000000283988OtherOHANTHEM BC/BS
Q035419OtherOHTHE HEALTH PLAN
000000186380OtherOHUNISON HEALTH PLAN
733560OtherOHBUCKEYE COMMUNITY HEALTH
341574729036OtherOHCARESOURCE
2401672MedicaidOH
341574729FOtherOHAULTCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040430001082 OH Practitioner - Critical Care (Intensivists)Practitioner - Pulmonary Disease 4789672684 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Critical Care (Intensivists)Also: Pulmonary Disease
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aultman HospitalGroup PAC ID 3779485867, 41 clinicians
Pulmonary Physicians IncGroup PAC ID 2264429117, 11 clinicians

Practice addresses (Care Compare)

2600 6TH St SW
Canton, OH 44710-1702
Phone (330) 452-9911

2600 Tuscarawas St W
Suite 100
Canton, OH 44708-4696
Phone (330) 452-8844

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.44 of 100Reported as individual
Quality
80
Promoting interoperability
100
Improvement activities
40
Cost
80.27

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
35-065732OHMDCritical Care Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aultman Hospital CurrentSince May 1, 2023 Accepting new patients
Aultman Hospital Current Accepting new patients
Aultman Hospital CurrentSince May 1, 2023 Accepting new patients
Orrville Hospital Foundation CurrentSince May 1, 2023 Accepting new patients
Orrville Hospital Foundation CurrentSince May 1, 2023 Accepting new patients
Akron Children's Hospital Current Accepting new patients
Select Specialty Hospital - Northeast Ohio Inc Past Accepting new patients

Locations

2600 6th St SW
Canton, OH 44710
Phone (330) 363-2180

2600 Tuscarawas St W
Ste 100
Canton, OH 44708
Phone (330) 452-8844

832 S Main St
Orrville, OH 44667
Phone (330) 456-2695

Interoperability endpoints

  • Direct secure messaging: nboutros118579@direct.chmca.org
  • Direct secure messaging: nihadboutros@ppoh.allscriptsdirect.net

Organizations & group practices 8

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.

Hospital & facility affiliations 4

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": "1116892800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294185600000",
    "number": "1508869454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 TUSCARAWAS ST W",
            "address_2": "STE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084696",
            "telephone_number": "330-452-8844",
            "fax_number": "330-452-7012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 TUSCARAWAS ST W",
            "address_2": "STE 100",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447084696",
            "telephone_number": "330-452-8844",
            "fax_number": "330-452-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTROS",
        "first_name": "NIHAD",
        "middle_name": "M",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-05-24",
        "last_updated": "2011-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Critical Care Medicine",
            "state": "OH",
            "license": "35-065732",
            "primary": true
        },
        {
            "code": "207RP1001X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Pulmonary Disease",
            "state": "OH",
            "license": "35-065732",
            "primary": false
        },
        {
            "code": "207RS0012X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Sleep Medicine",
            "state": "OH",
            "license": "35-065732",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BC/BS",
            "identifier": "000000283988",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "THE HEALTH PLAN",
            "identifier": "Q035419",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNISON HEALTH PLAN",
            "identifier": "000000186380",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BUCKEYE COMMUNITY HEALTH",
            "identifier": "733560",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CARESOURCE",
            "identifier": "341574729036",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2401672",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AULTCARE",
            "identifier": "341574729F",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, OH

Sources for this page

Verify at the official NPI Registry.