DR. JAY BOUGHANEM (MD) – Orthopaedic Surgery Physician, NPI 1518115948
Orthopaedic Surgery Physician
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Profile Insights
NPPES metrics only — not quality of care.
1,265 ORTHOPEDIC SURGERY in IL
Provider Addresses for DR. JAY BOUGHANEM (MD)
676 N SAINT CLAIR ST FL 13
DEPARTMENT OF ORTHOPAEDIC SURGERY
CHICAGO, IL 606113060
Phone: (312) 926-4485
Type: Location
1626 Tuttle St
Baraboo, WI 539131501
Phone: (608) 355-6868
Fax: (608) 356-6787
Type: Location
2718, North Wilton Avenue, Lincoln Park, Lakeview, Chicago, Lake View Township, Cook County, Illinois, 60614, United States
UNIT 2
CHICAGO, IL 606142875
Phone: (312) 371-1861
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 26 Open Payments records for all available years, with a total value of $4,460.
Total Amount is formed as General ($4,460) + Research ($0) + Ownership ($0) = $4,460.
Last reported payment date: 2024-10-27 • Largest payer in this snapshot: Zimmer Biomet Holdings, Inc. ($3,601).
Total Amount
$4,460
General + Research + Ownership
Payments
26
Total payment records
General Amount
$4,460
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-10-27
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Zimmer Biomet Holdings, Inc. | $3,601 |
| Stryker Corporation | $798 |
| Spinal Simplicity, LLC | $33 |
| Smith+Nephew, Inc. | $28 |
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: 2026-02-26
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 4 Medicare enrollment records; no due dates published yet.
Enrollment records
4
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110929000180 | I | Orthopedic Surgery | HI | TBD |
| I20231130003840 | I | Orthopedic Surgery | OR | TBD |
| I20260106003362 | I | Orthopedic Surgery | NV | TBD |
| I20260226001700 | I | Orthopedic Surgery | CA | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 207 | 99 | $0 |
| 99204 | New patient office or other outpatient visit, 45-59 minutes | 80 | 80 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 32 | 27 | $0 |
| 23430 | Anchoring of biceps tendon | 11 | 11 | $0 |
Insurance plans in this area (ZIP 60611)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| ORTHOPEDIC SURGERY | IL | 20610 | Aspiration and/or injection of large joint or joint capsule | 49 | 41 |
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