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MARY ROSE BOUTROS AGNP
NPI 1285116822
Nurse Practitioner - Gerontology in Tinton Falls, NJ

Active since August 30, 2018PECOS Enrolled
22 TOPEKA CT, TINTON FALLS, NJ 07712(732) 618-7718 Get Directions Write a Review

NPPES record last updated: April 21, 2026. Verified against the NPPES registry weekly; last sync: August 23, 2026.

Record update history: Apr 21, 2026, Aug 30, 2018 (2 updates tracked since 2018).

About Mary Rose Boutros Agnp NPPES

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

MARY ROSE BOUTROS AGNP (NPI 1285116822) is an individual gerontology provider in Tinton Falls, New Jersey, licensed in New Jersey (26NJ00851300) and active in the NPI registry since August 2018. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1285116822
Entity TypeIndividualFemale
Primary Taxonomy363LG0600X
Provider Legal NameMARY ROSE BOUTROSCredential: AGNP
Location Address22 TOPEKA CTTinton Falls, NJ 07712-7508
Mailing Address22 Topeka CtTinton Falls, NJ 07712-7508 · (732) 618-7718
Phone(732) 618-7718
Sole ProprietorNo
Enumeration DateAugust 30, 2018
Last NPPES UpdateApril 21, 20262 updates tracked since enumeration
NPPES CertifiedApril 21, 2026
✔ NPI 1285116822 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyNurse Practitioner · GerontologyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LG0600X
License✔ Licensed in NJ · 26NJ00851300
Also ListedNurse Practitioner · Adult HealthTaxonomy 363LA2200X · License 26NJ00851300 (NJ)
22 TOPEKA CT, Tinton Falls, NJ 07712
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mary Rose Boutros Agnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 07712 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
$94.90 typical visit price
range $61.59 – $185.05
Typical copayment $23.72 (range $15.39 – $46.26)
Most-billed visit code 99203
Established Patient
$107.94 typical visit price
range $20.08 – $150.98
Typical copayment $26.98 (range $5.02 – $37.74)
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.

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 Mary Rose Boutros's NPI number?

The NPI number for Mary Rose Boutros is 1285116822. It was assigned to this individual provider in the NPPES registry on August 30, 2018.

Where is Mary Rose Boutros located?

Mary Rose Boutros practices at 22 Topeka Ct, Tinton Falls, NJ 07712. The listed phone number is (732) 618-7718.

What is Mary Rose Boutros's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Gerontology, with taxonomy code 363LG0600X.

Is Mary Rose Boutros enrolled in Medicare?

Yes. Mary Rose Boutros is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Mary Rose Boutros was last updated on April 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 months 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.