MARIANNE BOUTROS (PA-C) – Physician Assistant, NPI 1215740501

MARIANNE BOUTROS (PA-C) is a healthcare provider. based in West palm beach, Florida. specializing in PHYSICIAN ASSISTANT. They hold the professional credentials PA-C. The NPI Number for MARIANNE BOUTROS (PA-C) is 1215740501

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
MARIANNE BOUTROS (PA-C)
NPI
1215740501
Phone
(772) 403-2227
Address
8645 N MILITARY TRL STE 508
Enumeration Date
30 January 2025
Last Update Date
7 November 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4078467546
Graduation Year
2024 (2 years ago)
PAC ID
2567986862
Group Practice PAC ID
1355334863
Professional Enrollment ID
I20250408002670
Address ID
FL347115056CL1655X50XX401
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience17
Completeness85
Years active:1State licenses:0Digital endpointsOther names

9,231 PHYSICIAN ASSISTANT in FL

Provider Addresses for MARIANNE BOUTROS (PA-C)

  • 8645 N MILITARY TRL STE 508

    WEST PALM BEACH, FL 334106296

    Phone: (772) 403-2227

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-04-08

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250408002670IPhysician AssistantFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33410)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1355334863View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerFL
General Surgery, Plastic And Reconstructive SurgeryFL
Nurse PractitionerFL
Dermatology, Micrographic Dermatologic Surgery (Mds)FL
-FL
Physician AssistantFL
D E R M A T O L O G YFL
Physician AssistantFL
Physician AssistantFL

Reviews

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Frequently asked questions

What is the standard ID for MARIANNE BOUTROS (PA-C) in the U.S.?
In the U.S., MARIANNE BOUTROS (PA-C) is identified by NPI 1215740501.
Does the public listing show MARIANNE BOUTROS (PA-C) as active?
MARIANNE BOUTROS (PA-C)'s NPI record reflects an active status in NPPES.
How should patients interpret MARIANNE BOUTROS (PA-C)'s specialty?
The extract shows Physician Assistant for MARIANNE BOUTROS (PA-C). Clinical services aligned with this taxonomy classification.
Is MARIANNE BOUTROS (PA-C) tied to West Palm Beach, Florida?
If you are local to West Palm Beach, Florida, MARIANNE BOUTROS (PA-C) may be relevant to your search.
Why is information missing for MARIANNE BOUTROS (PA-C)?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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