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DR. SHADI BOUTROS DDS
NPI 1457489239
Dentist - Oral and Maxillofacial Surgery in Martinez, CA

Active since March 01, 2007PECOS Enrolled
2500 ALHAMBRA AVE, MARTINEZ, CA 94553(925) 370-5200 Get Directions Write a Review

NPPES record last updated: May 13, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Shadi Boutros Dds NPPES

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

DR. SHADI BOUTROS DDS (NPI 1457489239) is an individual oral and maxillofacial surgery provider in Martinez, California, licensed in California (54887) and active in the NPI registry since March 2007. He is enrolled in Medicare PECOS and is a graduate of University Of Southern California Keck School Of Medicine (2011).

NPPES Registry Identity

NPI1457489239
Entity TypeIndividualMale
Primary Taxonomy1223S0112X
Provider Legal NameDR. SHADI BOUTROSCredential: DDS
Location Address2500 ALHAMBRA AVEMartinez, CA 94553-3156
Mailing Address2500 Alhambra AveMartinez, CA 94553-3156 · (925) 370-5200
Phone(925) 370-5200
Sole ProprietorNo
Medical School CMSUniversity Of Southern California Keck School Of MedicineGraduated 2011
Enumeration DateMarch 1, 2007
Last NPPES UpdateMay 13, 2015
✔ NPI 1457489239 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · Oral and Maxillofacial SurgeryDental Providers
Taxonomy Code1223S0112X
License✔ Licensed in CA · 54887
Definition
An oral and maxillofacial surgery dentist specialized in the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region.
2500 ALHAMBRA AVE, Martinez, CA 94553
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas 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 (PECOS)

Dr. Shadi Boutros Dds is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID6901107531
PECOS Enrollment IDI20260327001565
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 94553 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
$104.51 typical visit price
range $69.00 – $202.35
Typical copayment $26.12 (range $17.25 – $50.58)
Most-billed visit code 99203
Established Patient
$84.91 typical visit price
range $23.44 – $166.46
Typical copayment $21.22 (range $5.86 – $41.61)
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 20

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

JOHN S HAWKINS
Family Medicine
2500 ALHAMBRA AVE
MARTINEZ, CA 94553
Contra Costa County (925) 370-5200
HYAEJEEN JEON
Student in an Organized Health Care Education/Training Program
2500 ALHAMBRA AVE
MARTINEZ, CA 94553
Contra Costa County (925) 370-5117
RONALD POWER DDS
Dentist
2500 ALHAMBRA AVE
MARTINEZ, CA 94553
Contra Costa County (925) 370-5110
DR. SARA JOSEPHINE RICHEY-LUCERO M.D.
General Practice
2500 ALHAMBRA AVE
MARTINEZ, CA 94553
Contra Costa County (925) 370-5182
CHARLOTTE STANDEFER
Family Medicine
2500 ALHAMBRA AVE
MARTINEZ, CA 94553
Contra Costa County (925) 370-5110
RICHARD NAGLE
Surgery
2500 ALHAMBRA AVE
MARTINEZ, CA 94553
Contra Costa County (925) 370-5110
CHRISTIAN MICHAEL EISERT MD, MPH
Otolaryngology
2500 ALHAMBRA AVE
MARTINEZ, CA 94553
Contra Costa County (925) 370-5000
ZOHAIB ABBASI
Psychiatry & Neurology (Psychiatry)
2500 ALHAMBRA AVE, PES
MARTINEZ, CA 94553
Contra Costa County (415) 409-9492

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 Shadi Boutros's NPI number?

The NPI number for Shadi Boutros is 1457489239. It was assigned to this individual provider in the NPPES registry on March 1, 2007.

Where is Shadi Boutros located?

Shadi Boutros practices at 2500 Alhambra Ave, Martinez, CA 94553. The listed phone number is (925) 370-5200.

What is Shadi Boutros's specialty?

The primary specialty registered for this NPI is Dentist, specializing in Oral and Maxillofacial Surgery, with taxonomy code 1223S0112X.

Is Shadi Boutros enrolled in Medicare?

Yes. Shadi Boutros is registered in the Medicare PECOS enrollment system.

What insurance does Shadi Boutros accept?

Health plans from Blue Cross and Blue Shield of Montana, Blue Cross and Blue Shield of Oklahoma, Blue Cross and Blue Shield of Texas, HRI Dental & Vision and Humana and 2 other insurers list Shadi 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 Shadi Boutros was last updated on May 13, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.