Catherine Anna Boutros, MD

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

593 Eddy St
Providence, RI 02903-4923

Phone

(401) 444-4000

NPI assigned

Apr 26, 2022

Last updated

Jun 22, 2023By the provider in NPPES

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

Medicare fee-for-service enrollment

Enrolled in RI

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1650931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687392000000",
    "number": "1881338754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 STATION PLZ N STE 509",
            "city": "MINEOLA",
            "state": "NY",
            "postal_code": "115013893",
            "telephone_number": "516-663-2381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "593 EDDY ST",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029034923",
            "telephone_number": "401-444-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTROS",
        "first_name": "CATHERINE",
        "middle_name": "ANNA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-04-26",
        "last_updated": "2023-06-22",
        "certification_date": "2023-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "RI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Meredith Ealise Bourque, RN
• Julie Anne Bousquet-Eulie, LMHC
• Kelsey Lynn Bousquet, OTR
• Lindsey Bousquet, OTR/L
• Boustani Periodontics PC
• Michelle Bouyssou
• Robert Patrick Bowe, CHT
• Lawrence P Bowen, M. D.
• Matthew J Bowen, PH.D.
• Roberta M Bowen, NNP

• Student in an Organized Health Care Education/Training Program in Providence, RI
• Providers in Providence, RI by specialty
• Student in an Organized Health Care Education/Training Program in Rhode Island

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2023; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.