ANDREW STEPHEN BOUTSICARIS
NPI 1164009023
Internal Medicine - Endocrinology, Diabetes & Metabolism in Chicago, IL
About Andrew Stephen Boutsicaris NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
ANDREW STEPHEN BOUTSICARIS (NPI 1164009023) is an individual endocrinology, diabetes & metabolism provider in Chicago, Illinois, licensed in Illinois (036.167216) and active in the NPI registry since March 2021. He is enrolled in Medicare PECOS, is affiliated with Loyola University Medical Center, and is a graduate of Other (2021).
NPPES Registry Identity
Specialties & Licenses 3
Other Names 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare and accepts Medicare assignment
Andrew Stephen Boutsicaris 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.
Medicare Billing Reassignments
2Medicare enrollment records show Andrew Boutsicaris reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Berwyn, IL 60402
- Reassigned Medicare billing, Illinois enrollment
- 211 clinicians in this Medicare group
Maywood, IL 60153
- Reassigned Medicare billing, Illinois enrollment
- 1,138 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
Loyola University Medical Center
Acute Care Hospitals · Maywood, ILPhysician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 60611 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 20
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
CHICAGO, IL 60611
CHICAGO, IL 60611
CHICAGO, IL 60611
CHICAGO, IL 60611
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 Andrew Boutsicaris's NPI number?
The NPI number for Andrew Boutsicaris is 1164009023. It was assigned to this individual provider in the NPPES registry on March 26, 2021. The provider is also known as Andrew Stephen Vidalis.
Where is Andrew Boutsicaris located?
Andrew Boutsicaris practices at 420 E Superior St, Chicago, IL 60611. The listed phone number is (312) 926-2000.
What is Andrew Boutsicaris's specialty?
The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.
Is Andrew Boutsicaris enrolled in Medicare?
Yes. Andrew Boutsicaris 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.
Which organizations bill Medicare for Andrew Boutsicaris's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Andrew Boutsicaris reassigns Medicare benefits to 2 organizations: Loyola Medical Group LLC (Berwyn, IL) and Loyola University Medical Center (Maywood, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Andrew Boutsicaris's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Andrew Boutsicaris accept?
Health plans from Oscar Health list Andrew Boutsicaris 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.
Is Andrew Boutsicaris affiliated with any hospitals?
According to CMS data, Andrew Boutsicaris is affiliated with Loyola University Medical Center.
When was this NPI record last updated?
The NPPES record for Andrew Boutsicaris was last updated on June 27, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.
# Andrew Stephen Boutsicaris · NPI 1164009023
Endocrinology, Diabetes & Metabolism physician in Chicago, Illinois. Individual provider, active in the CMS NPPES registry since March 26, 2021.
## Identity
- **NPI:** 1164009023 (Entity type: Individual)
- **Enumerated:** March 26, 2021
- **Primary specialty:** Internal Medicine - Endocrinology, Diabetes & Metabolism · taxonomy 207RE0101X
- **State license:** 036.167216 (Illinois)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 420 E SUPERIOR ST, Chicago, IL 60611-4494
- **Phone:** (312) 926-2000
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Loyola Medical Group LLC (NPI 1376041954, Berwyn, IL); Loyola University Medical Center (NPI 1336159961, Maywood, IL) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** Other, class of 2021
## Record status
- **NPPES last updated:** June 27, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1164009023) · Data from the CMS NPPES public registry.