Individual provider Active NPI

Alexander George Boutselis, MD

  • Diagnostic Radiology Physician
  • Scottsdale, AZ
National Provider Identifier
1831167147
Registry record updated Jan 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
42605 Issued in AZ
Practice address
13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone
(480) 301-8000
NPI assigned
Mar 11, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 2, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X 01046468A IN
Diagnostic Radiology Physician 2085R0202X 42605 AZ Primary

Addresses

Primary practice location

13400 E Shea Blvd
Scottsdale, AZ 85259-5499

Mailing address

13400 E Shea Blvd
Scottsdale, AZ 85259-5499
Phone (480) 301-8000

Other practice location 1

550 University Blvd
Indianapolis, IN 46202-5149
Phone (317) 944-4600

Other identifiers 1

IdentifierTypeStateIssuer
200166030MedicaidIN

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address aboutselis@direct.iuhealth.org
Direct Messaging Address aboutselis2391382@ehrdirect.mayoclinicmsg.org

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN, FL, CA, AZ4 enrollments
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 4

Enrollment IDStateProvider typePAC IDDetails
I20040713001521 IN Practitioner - Diagnostic Radiology 8628965779 Reassigns benefits to 1 organization
I20111101000580 FL Practitioner - Diagnostic Radiology 8628965779 Reassigns benefits to 1 organization
I20120816000902 CA Practitioner - Diagnostic Radiology 8628965779
I20230131001929 AZ Practitioner - Diagnostic Radiology 8628965779 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Ohio State University College of Medicine, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayo Clinic ArizonaGroup PAC ID 7012829930, 1,618 clinicians

Practice addresses (Care Compare)

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone (480) 301-8000

Hospital & facility affiliations

  • Mayo Clinic Hospital Hospital, Phoenix, AZ, CCN 030103

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01046468AINMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Pdi Toledo, LLC Diagnostic Radiology CurrentSince Feb 21, 2024 Accepting new patients
Mayo Clinic Arizona CurrentSince Nov 18, 2024 Accepting new patients
Indiana University Radiology Associates, Inc. Diagnostic Radiology CurrentSince Dec 1, 2016 Accepting new patients
Pdi Toledo, LLC Diagnostic Radiology CurrentSince Feb 21, 2024 Accepting new patients
Open MRI of Steubenville, LTD CurrentSince Nov 1, 2022 Accepting new patients
Mayo Clinic Arizona CurrentSince Nov 18, 2024 Accepting new patients
Elite Imaging LLC Diagnostic Radiology Current Accepting new patients
Integra Imaging Partners LLC Diagnostic Radiology Past Accepting new patients
Lafayette Radiology LLC Diagnostic Radiology Past Accepting new patients
Nufinity, LLC Diagnostic Radiology Past Accepting new patients
United Diagnostics PLLC Diagnostic Radiology Past Accepting new patients
American Imaging and MRI, LLC Diagnostic Radiology Past Accepting new patients
Altamonte Springs Diagnostic Imaging Inc Diagnostic Radiology PastSince Jun 16, 2010 Accepting new patients

Locations

5777 E Mayo Blvd
Phoenix, AZ 85054
Phone (480) 342-1800

13400 E Shea Blvd
Scottsdale, AZ 85259

Dept AT 952561
Atlanta, GA 31192

5924 Reliable Pkwy
Chicago, IL 60686

2900 16th St
Bedford, IN 47421
Phone (812) 275-1200

1701 Senate Blvd
#C6
Indianapolis, IN 46202
Phone (317) 962-9000

250 N Shadeland Ave
Indianapolis, IN 46219
Phone (317) 948-9174

250 N Shadeland Ave
Ste 200
Indianapolis, IN 46219
Phone (317) 962-4836

550 University Blvd
Indianapolis, IN 46202
Phone (217) 274-5000

110 Main St
Wintersville, OH 43953
Phone (740) 264-6440

Networks

  • Freedom Health HMO Network

Organizations & group practices 13

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.

View all 13

Hospital & facility affiliations 1

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": "1142035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735776000000",
    "number": "1831167147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595499",
            "telephone_number": "480-301-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13400 E SHEA BLVD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852595499",
            "telephone_number": "480-301-8000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "550 University Blvd",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462025149",
            "country_code": "US",
            "telephone_number": "317-944-4600",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUTSELIS",
        "first_name": "ALEXANDER",
        "middle_name": "GEORGE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-11",
        "last_updated": "2025-01-02",
        "certification_date": "2025-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "IN",
            "license": "01046468A",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "AZ",
            "license": "42605",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200166030",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aboutselis@direct.iuhealth.org",
            "affiliation": "N",
            "address_1": "550 University Blvd",
            "city": "Indianapolis",
            "state": "IN",
            "country_code": "US",
            "postal_code": "462025149",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "aboutselis2391382@ehrdirect.mayoclinicmsg.org",
            "affiliation": "N",
            "address_1": "13400 E Shea Blvd",
            "city": "Scottsdale",
            "state": "AZ",
            "country_code": "US",
            "postal_code": "852595499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

Verify at the official NPI Registry.