GAMAL S BOUTROS M.D.
NPI 1235168949
Psychiatry & Neurology - Neurology in Johnson City, TN
NPI Status: Active since July 03, 2006
Contact Information
809 LAMONT ST
JOHNSON CITY, TN
ZIP 37604
Phone: (423) 926-1171
Fax: (423) 282-8533
- Individual
- Male
- Psychiatry & Neurology
- Neurology
- PECOS Enrolled
- Medicare Quality Reporting
About GAMAL BOUTROS
This page provides the complete NPI Profile along with additional information for Gamal Boutros, a provider established in Johnson City, Tennessee with a medical specialization in Psychiatry & Neurology, focusing in neurology . The healthcare provider is registered in the NPI registry with number 1235168949 assigned on July 2006. The practitioner's primary taxonomy code is 2084N0400X with license number MD0000027959 (TN). The provider is registered as an individual and his NPI record was last updated 2 years ago.
- NPI
- 1235168949
- Provider Name
- GAMAL S BOUTROS M.D.
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 809 LAMONT ST JOHNSON CITY, TN 37604
- Location Phone
- (423) 926-1171
- Location Fax
- (423) 282-8533
- Mailing Address
- 809 LAMONT ST STE 1 JOHNSON CITY, TN 37604
- Mailing Phone
- (423) 926-1171
- Mailing Fax
- (423) 282-8533
- Is Sole Proprietor?
- No
- Enumeration Date
- 07-03-2006
- Last Update Date
- 06-07-2023
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Psychiatry & Neurology Neurology
- Taxonomy Code
- 2084N0400X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- MD0000027959
- License State
- TN
- Taxonomy Description
- A Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures.
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 4037855 | OTHER (01) | TN | BCBS |
| 721513353 | OTHER (01) | TN | UNITED HEALTHCARE |
| 0237660KP | OTHER (01) | TN | JOHN DEERE HEALTH |
| 3800768 | MEDICAID (05) | TN |
Medicare Participation & PECOS Enrollment Status
Gamal Boutros is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
Established patient office or other outpatient visit, 20-29 minutes
Established patient office or other outpatient visit, 30-39 minutes
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.
This service was performed 39 times for 38 patientsThis 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.
This service was performed 22 times for 22 patientsPhysician Visit Costs
The pricing information below displays the copayment minimum, maximum and average amount that patients under Medicare are charged when visiting this provider as a new or established patient. Please keep in mind that these prices are just for reference purposes, and the actual prices charged by the provider might be different.
For patients covered under private health plans the prices below are also useful as healthcare pricing for private insurance is usually established as a function of Medicare prices. Private insurance covered patients should check their individual plans to determine the exact pricing.
The prices below reflect the costs for new and established patients in the 37604 ZIP code area.
New Patients Visit Costs *
The most utilized procedure code for new patients office visits is 99204
- Average New Patient Price $121.8
- Minimum New Patient Price $52.64
- Maximum New Patient Price $160.89
- Average New Patient Copayment $30.45
- Minimum New Patient Copayment $13.16
- Maximum New Patient Copayment $40.22
Established Patients Visit Costs *
The most utilized procedure code for established patients office visits is 99214
- Average Established Patient Price $93.6
- Minimum Established Patient Price $16.72
- Maximum Established Patient Price $131.41
- Average Established Patient Copayment $23.4
- Minimum Established Patient Copayment $4.18
- Maximum Established Patient Copayment $32.85
* The physician office visit costs information is generated by statistical analysis of similar providers in the same geographical area. The pricing information above IS NOT the amount charged by this provider.
Quality Reporting
The provider participated in CMS Quality Payment Program. The Quality Payment Program aims to improve population health, reduce costs and improve the care received by Medicare beneficiaries. The following quality measures meet Medicare's statistical reporting standards. Not all providers report the same information, because not all providers give the same services to patients. The quality information is just a snapshot of some the care providers give to their patients. Reporting more or less information is not a reflection of quality.
| Quality Measure | Performance | Number of Patients |
|---|---|---|
| Annual registration in the Prescription Drug Monitoring Program | Yes | N/A |
| Annual registration by eligible clinician or group in the prescription drug monitoring program of the state where they practice. Activities that simply involve registration are not sufficient. MIPS eligible clinicians and groups must participate for a minimum of 6 months. | ||
| Depression screening | Yes | N/A |
| Depression screening and follow-up plan: Regular engagement of MIPS eligible clinicians or groups in integrated prevention and treatment interventions, including depression screening and follow-up plan (refer to NQF #0418) for patients with co-occurring conditions of behavioral or mental health conditions. | ||
| Engagement of New Medicaid Patients and Follow-up | Yes | N/A |
| Seeing new and follow-up Medicaid patients in a timely manner, including individuals dually eligible for Medicaid and Medicare. A timely manner is defined as within 10 business days for this activity. | ||
| Use evidence-based decision aids to support shared decision-making. | Yes | N/A |
| Use evidence-based decision aids to support shared decision-making. | ||
| Use of telehealth services that expand practice access | Yes | N/A |
| Use of telehealth services and analysis of data for quality improvement, such as participation in remote specialty care consults or teleaudiology pilots that assess ability to still deliver quality care to patients. | ||
Reviews for GAMAL S BOUTROS M.D.
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 2 | 3 | 5 | 1 | 6 | 8 | 9 | 4 | 9 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 2 | 6 | 5 | 2 | 6 | 16 | 9 | 8 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 2 + 6 + 5 + 2 + 6 + 1 + 6 + 9 + 8 + 24 = 71 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 71 = 9 | 9 | ||||||||
The NPI number 1235168949 is valid because the calculated check digit 9 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1013407709 | DR. HEATHER MORGAN JOHNSON DPM Individual | Podiatrist | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1083185755 | CAMERON H ATKISON OTR Individual | Occupational Therapist | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1356684229 | DR. MEHDI POURMORTEZA D.O. Individual | Internal Medicine | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1982176483 | SAMANTHA D CLARK LMSW Individual | Social Worker | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 335-0863 |
| 1457911539 | REBECCA HOLT PHARM.D., BCPS Individual | Pharmacist (Pharmacotherapy) | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1689206427 | RACHEL LEANN STOUT-CUNNYNGHAM NP Individual | Nurse Practitioner (Family) | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1861012627 | AMANDA SHANKEL RN BSN Individual | Registered Nurse | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1982215430 | ISAAC MATTHEW SHEPARD WEAVER RN Individual | Registered Nurse (Medical-Surgical) | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1124632831 | MARY HELEN FUQUA CTRS Individual | Recreation Therapist | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1639786486 | DR. CARMEN MICHELLE MEADOWS PHARMD Individual | Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist) | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1902403330 | MICHELE GARCIA LMSW Individual | Social Worker | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1205425048 | BRAD A BROYLES Individual | Registered Nurse | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1043896079 | HUNTER KELSEY CLARK Individual | Registered Nurse | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 306-1716 |
| 1528591443 | DR. TAMIE D WELLS MD Individual | Psychiatry & Neurology (Psychiatry) | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 677-7463 |
| 1407823842 | DR. MICHAEL S PUTHOFF MD Individual | Family Medicine | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1659956043 | BETHEL SEBSIBE DUFFIN PMHNP-BC Individual | Nurse Practitioner (Psychiatric/Mental Health) | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1629703541 | JESSICA LEIGH HOWINGTON PHARMD Individual | Pharmacist | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1669199782 | CHANDLER COLLINS Individual | Social Worker (Clinical) | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1801408281 | CAPRISSE R HONSBRUCH PHARMD Individual | Pharmacist | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
| 1942927033 | RONNIE JO ARMSTRONG RDN Individual | Dietitian, Registered | 809 LAMONT ST JOHNSON CITY, TN 37604 (423) 926-1171 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1235168949, enumerated in the NPI registry as an "individual" on July 03, 2006
The provider is located at 809 Lamont St Johnson City, Tn 37604 and the phone number is (423) 926-1171
The provider's speciality is Psychiatry & Neurology with taxonomy code 2084N0400X with a focus in Neurology
The provider might be accepting Accepts: Blue Cross Blue Shield, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
Medicare beneficiaries should expect a typical cost of $121.8 with an average copayment of $30.45 for new patient appointments. Established patients should expect a typical charge of $93.6 and an average copayment of 23.4. Please review your insurance plan or contact the provider directly to determine your specific costs.
The most common procedures or services performed by this practitioner are: Established patient office or other outpatient visit, 20-29 minutes and Established patient office or other outpatient visit, 30-39 minutes.
This NPI record was last updated on July 03, 2006. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
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