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MISS LOURICE BOUTROS OD
NPI 1083109904
Optometrist in Pasadena, CA

Active since June 22, 2018PECOS EnrolledAccepts Medicare Assignment
3235 E COLORADO BLVD STE 101, PASADENA, CA 91107(626) 765-6634 Get Directions Write a Review

NPPES record last updated: October 29, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Oct 29, 2019, May 22, 2019, Jun 22, 2018 (3 updates tracked since 2018).

About Miss Lourice Boutros Od NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS LOURICE BOUTROS OD (NPI 1083109904) is an individual optometrist in Pasadena, California, licensed in California (33939TLG) and active in the NPI registry since June 2018. She is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Southern California College Of Optometry (2017).

NPPES Registry Identity

NPI1083109904
Entity TypeIndividualFemale
Primary Taxonomy152W00000X
Provider Legal NameMISS LOURICE BOUTROSCredential: OD
Location Address3235 E COLORADO BLVD STE 101Pasadena, CA 91107
Mailing Address3235 E Colorado Blvd Ste 101Pasadena, CA 91107-3837 · (626) 765-6634
Phone(626) 765-6634
Sole ProprietorNo
Medical School CMSSouthern California College Of OptometryGraduated 2017
Enumeration DateJune 22, 2018
Last NPPES UpdateOctober 29, 20193 updates tracked since enumeration
✔ NPI 1083109904 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyOptometristEye and Vision Services Providers
Taxonomy Code152W00000X
License✔ Licensed in CA · 33939TLG
Definition
Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system.
3235 E COLORADO BLVD STE 101, Pasadena, CA 91107
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Secondary Practice Locations 2

Location 12771 Rowena AveLos Angeles, CA 90039-2720 · Phone (323) 664-1996
Location 2477 E Colorado BlvdPasadena, CA 91101-2024 · Phone (626) 588-2020

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Louisiana, Blue Cross Blue Shield of Wyoming, BlueCross BlueShield of Tennessee and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Miss Lourice Boutros Od is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7517394430
PECOS Enrollment IDI20200305000320
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 5

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Photography of the retina 92250
Photography of the retina, also known as retinal imaging, is a non-invasive procedure that captures images of the back of your eye. This helps doctors identify and monitor conditions like glaucoma, macular degeneration, or diabetic retinopathy. It's painless and quick, often part of a routine eye exam.
51 services44 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
42 services32 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
30 services30 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
20 services17 patients
Imaging of retina 92134
Imaging of the retina is a non-invasive procedure that captures detailed images of your eye's interior. This helps detect conditions like macular degeneration or retinal detachment. It's painless and takes only a few minutes.
12 services11 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 91107 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$142.39 typical visit price
range $62.96 – $187.60
Typical copayment $35.59 (range $15.74 – $46.90)
Most-billed visit code 99204
Established Patient
$77.96 typical visit price
range $20.84 – $153.61
Typical copayment $19.49 (range $5.21 – $38.40)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DEDICATED TO HEALING MEDICAL GROUP
General Practice
3235 E COLORADO BLVD STE 101
PASADENA, CA 91107
Los Angeles County (626) 799-0557

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lourice Boutros's NPI number?

The NPI number for Lourice Boutros is 1083109904. It was assigned to this individual provider in the NPPES registry on June 22, 2018.

Where is Lourice Boutros located?

Lourice Boutros practices at 3235 E Colorado Blvd Ste 101, Pasadena, CA 91107. The listed phone number is (626) 765-6634.

What is Lourice Boutros's specialty?

The primary specialty registered for this NPI is Optometrist with taxonomy code 152W00000X.

Is Lourice Boutros enrolled in Medicare?

Yes. Lourice Boutros is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Lourice Boutros accept?

Health plans from Blue Cross Blue Shield of Wyoming, Blue Cross and Blue Shield of Louisiana, BlueCross BlueShield of Tennessee and Providence Health Plan list Lourice Boutros as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lourice Boutros was last updated on October 29, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.