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ANDREW STEPHEN BOUTSICARIS
NPI 1164009023
Internal Medicine - Endocrinology, Diabetes & Metabolism in Chicago, IL

Active since March 26, 2021PECOS Enrolled
420 E SUPERIOR ST, CHICAGO, IL 60611(312) 926-2000 Get Directions Write a Review

NPPES record last updated: June 27, 2024. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 27, 2024, May 12, 2021, Mar 26, 2021 (3 updates tracked since 2021).

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 and is a graduate of Other (2021).

NPPES Registry Identity

NPI1164009023
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameANDREW STEPHEN BOUTSICARIS
Location Address420 E SUPERIOR STChicago, IL 60611-4494
Mailing Address420 E Superior StChicago, IL 60611-4494
Phone(312) 926-2000
Sole ProprietorYes
Medical School CMSOtherGraduated 2021
Enumeration DateMarch 26, 2021
Last NPPES UpdateJune 27, 20243 updates tracked since enumeration
NPPES CertifiedJune 27, 2024
✔ NPI 1164009023 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 3

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
License✔ Licensed in IL · 036.167216
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedInternal MedicineTaxonomy 207R00000X · License 125.077394 (IL)
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
420 E SUPERIOR ST, Chicago, IL 60611
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Other Names 1

Former Name (1)Andrew Stephen Vidalis

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Andrew Stephen Boutsicaris is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID9335537489
PECOS Enrollment IDI20260717000336
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.

Physician 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.

New Patient
$138.86 typical visit price
range $60.08 – $183.39
Typical copayment $34.71 (range $15.02 – $45.84)
Most-billed visit code 99204
Established Patient
$105.70 typical visit price
range $18.97 – $148.12
Typical copayment $26.42 (range $4.74 – $37.03)
Most-billed visit code 99214
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 20

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

ERMYAS ASFHA KAHSAI
Student in an Organized Health Care Education/Training Program
420 E SUPERIOR ST
CHICAGO, IL 60611
Cook County (312) 503-8194
OLIVIA CONG
Student in an Organized Health Care Education/Training Program
420 E SUPERIOR ST
CHICAGO, IL 60611
Cook County (312) 503-8194
DR. ERICA GHIGNONE M.D.
Psychiatry & Neurology (Psychiatry)
420 E SUPERIOR ST, RUBLOFF BUILDING 12TH FLOOR
CHICAGO, IL 60611
Cook County (312) 503-8194
SEBASTIAN ALEXANDER HOAK MD
Psychiatry & Neurology (Child & Adolescent Psychiatry)
420 E SUPERIOR ST
CHICAGO, IL 60611
Cook County (312) 227-4000
KATHRYN MOTON-OSPINO MD
Pediatrics
420 E SUPERIOR ST
CHICAGO, IL 60611
Cook County (312) 503-7975
ARRIX RYCE MD
Radiology (Vascular & Interventional Radiology)
420 E SUPERIOR ST
CHICAGO, IL 60611
Cook County (312) 503-7975
DR. RAVI RAJARAM M.D.
Surgery
420 E SUPERIOR ST, RUBLOFF 12TH FLOOR
CHICAGO, IL 60611
Cook County (312) 503-7975
MUKUND GANDE MD
Anesthesiology
420 E SUPERIOR ST
CHICAGO, IL 60611
Cook County (609) 721-1940

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 enrollment system.

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.