DR. NIDAL BOUTROS
NPI 1629036173
Internal Medicine in Lebanon, MO

Q: What is Nidal Boutros's NPI number?

The NPI number for Nidal Boutros is 1629036173. It was assigned to this individual provider in the NPPES registry on May 3, 2006.

Q: What is Nidal Boutros's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Q: When was this NPI record last updated?

The NPPES record for Nidal Boutros was last updated on February 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.

Active since May 03, 2006PECOS EnrolledAccepts Medicare Assignment

120 HOSPITAL DR, SUITE 300, LEBANON, MO 65536(417) 533-6746(417) 533-6740 Get Directions Write a Review

NPPES record last updated: February 10, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

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About Dr. Nidal Boutros NPPES

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

DR. NIDAL BOUTROS (NPI 1629036173) is an individual internal medicine provider in Lebanon, Missouri, licensed in Missouri (2009027847) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with University Of Kansas Hospital, and is a graduate of Other (1990).

NPPES Registry Identity

NPI1629036173

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameDR. NIDAL BOUTROS

Location Address120 HOSPITAL DR, SUITE 300Lebanon, MO 65536-9238

Mailing AddressPo Box 505164Saint Louis, MO 63150-5164 · (417) 829-4620

Phone(417) 533-6746

Fax(417) 533-6740

Sole ProprietorNo

Medical School CMSOtherGraduated 1990

Enumeration DateMay 3, 2006

Last NPPES UpdateFebruary 10, 2022

✔ NPI 1629036173 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in MO · 2009027847

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

120 HOSPITAL DR, Lebanon, MO 65536

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Other Identifiers 1

Medicaid1629036173MO

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Home State Health, Ambetter from Sunflower Health Plan, Ambetter Health 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

Dr. Nidal Boutros 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 ID941303945

PECOS Enrollment IDI20170118000701

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 12

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.

Injection, denosumab, 1 mg J0897

Denosumab is a medication given via injection to strengthen your bones. It works by slowing down the cells that break down bone, improving bone density and reducing the risk of fractures. It's often used for osteoporosis treatment.

1,620 services18 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.

551 services292 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.

264 services197 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

233 services233 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

44 services23 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.

24 services24 patients

Administration of pneumococcal vaccine G0009

The pneumococcal vaccine helps protect against pneumococcal bacteria, which can cause severe infections like pneumonia and meningitis. The vaccine is given as an injection, typically in the arm. It's recommended for infants, older adults, and those with certain health conditions.

23 services23 patients

Influenza vaccine, inactivated 90653

The Influenza vaccine, inactivated, is a shot given to protect against the flu. It contains killed virus particles that help your body build immunity to the flu. It's recommended annually to keep your protection up-to-date. It's safe for ages 6 months and up.

17 services17 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

17 services17 patients

Pneumococcal vaccine, 23-valent 90732

The 23-valent pneumococcal vaccine is an injection that helps protect against serious infections caused by 23 types of pneumococcal bacteria. It's vital for those at risk, like older adults or people with certain health conditions, to prevent pneumonia, meningitis, and bloodstream infections.

12 services12 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

12 services12 patients

Pneumococcal conjugate vaccine, 20 valent (pcv20), for intramuscular use 90677

The Pneumococcal Conjugate Vaccine (PCV20) is a shot given to protect against 20 types of bacteria that can cause serious infections like pneumonia and meningitis. It's administered through a muscle, usually in the arm. It's important for overall health.

11 services11 patients

Hospital Affiliations CMS Care Compare 5

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

University Of Kansas Hospital

Acute Care Hospitals · Kansas City, KS

5/5 CMS rating

OwnershipGovernment - Hospital District or Authority

CMS Certification Number170040

Location4000 Cambridge StreetKansas City, KS 66160 · Wyandotte County

Emergency services Birthing friendly

Overland Park Reg Med Ctr

Acute Care Hospitals · Overland Park, KS

4/5 CMS rating

OwnershipProprietary

CMS Certification Number170176

Location10500 Quivira RoadOverland Park, KS 66215 · Johnson County

Emergency services Birthing friendly

Menorah Medical Center

Acute Care Hospitals · Overland Park, KS

3/5 CMS rating

OwnershipProprietary

CMS Certification Number170182

Location5721 West 119th StreetOverland Park, KS 66209 · Johnson County

Emergency services

Saint Luke's South Hospital

Acute Care Hospitals · Overland Park, KS

5/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number170185

Location12300 Metcalf AvenueOverland Park, KS 66213 · Johnson County

Emergency services

Belton Regional Medical Center

Acute Care Hospitals · Belton, MO

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number260214

Location17065 S 71 HighwayBelton, MO 64012 · Cass County

Emergency services

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 65536 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

$121.96 typical visit price

range $52.28 – $161.24

Typical copayment $30.49 (range $13.07 – $40.31)

Most-billed visit code 99204

Established Patient

$93.24 typical visit price

range $16.30 – $131.05

Typical copayment $23.31 (range $4.07 – $32.76)

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.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253

DME-Other DME · category DE017N

7 suppliers18 claims38 services$5.35 avg. paid by Medicare

Continuous positive airway pressure (cpap) device E0601

DME-Other DME · category DE001N

2 suppliers11 claims11 services$27.58 avg. paid by Medicare

Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553

DME-Other DME · category DE017N

1 supplier16 claims16 services$196.07 avg. paid by Medicare

Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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.

RICHARD MULRENIN LPC

Psychologist

120 HOSPITAL DR, STE 100
LEBANON, MO 65536

Laclede County (417) 533-6751

MORGANA HAZELL PSYD

Psychologist (Clinical)

120 HOSPITAL DR, SUITE 100
LEBANON, MO 65536

Laclede County (417) 820-3128

MERCY CLINIC-SPRINGFIELD COMMUNITIES

Clinic/Center (Rural Health)

120 HOSPITAL DR, SUITE 225
LEBANON, MO 65536

Laclede County (417) 533-6710

DEBRA A HOERTH CRNA

Nurse Anesthetist, Certified Registered

120 HOSPITAL DR
LEBANON, MO 65536

Laclede County (417) 533-6100

LISA M. BOGGS FNP-C

Nurse Practitioner (Family)

120 HOSPITAL DR, SUITE 300
LEBANON, MO 65536

Laclede County (417) 533-6746

RAJASEKHAR TANIKELLA MD

Hospitalist

120 HOSPITAL DR
LEBANON, MO 65536

Laclede County (417) 533-6100

DAVID HOUZENGA CRNA

Nurse Anesthetist, Certified Registered

120 HOSPITAL DR
LEBANON, MO 65536

Laclede County (417) 533-6100

MERCY CLINIC SPRINGFIELD COMMUNITIES

Durable Medical Equipment & Medical Supplies

120 HOSPITAL DR, SUITE 250
LEBANON, MO 65536

Laclede County (417) 533-6710

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 Nidal Boutros's NPI number?

The NPI number for Nidal Boutros is 1629036173. It was assigned to this individual provider in the NPPES registry on May 3, 2006.

Where is Nidal Boutros located?

Nidal Boutros practices at 120 Hospital Dr Suite 300, Lebanon, MO 65536. The listed phone number is (417) 533-6746.

What is Nidal Boutros's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is Nidal Boutros enrolled in Medicare?

Yes. Nidal 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 Nidal Boutros accept?

Health plans from Ambetter Health, Ambetter Health of Delaware, Ambetter from Home State Health, Ambetter from Sunflower Health Plan and Ambetter of Oklahoma and 3 other insurers list Nidal 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.

Is Nidal Boutros affiliated with any hospitals?

According to CMS data, Nidal Boutros is affiliated with University Of Kansas Hospital, Overland Park Reg Med Ctr, Menorah Medical Center, Saint Luke's South Hospital and Belton Regional Medical Center.

When was this NPI record last updated?

The NPPES record for Nidal Boutros was last updated on February 10, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.