JIMMY ROGER BOUTIN (M.D.) – Anesthesiology Physician, NPI 1417976937
Anesthesiology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for JIMMY ROGER BOUTIN (M.D.)
Biddle Subdivision, Wyandotte, Wayne County, Michigan, United States
WYANDOTTE, MI 481924668
Phone: (734) 246-7913
Fax: (734) 246-6968
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.
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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: 2011-01-06
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20110106000800 | I | Anesthesiology | MI | 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 |
|---|---|---|---|---|
| 00142 | Anesthesia for lens surgery | 168 | 158 | $0 |
| 00731 | Anesthesia for other procedure on esophagus, stomach, or upper small bowel using an endoscope | 40 | 39 | $0 |
| 00811 | Anesthesia for other procedure on large bowel using an endoscope | 37 | 37 | $0 |
| 01922 | Anesthesia for x-ray or radiation therapy | 20 | 20 | $0 |
| 00140 | Anesthesia for other procedure on eye | 19 | 18 | $0 |
Insurance plans in this area (ZIP 48192)
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Provider's Procedures
Group practice members
| Name | Specialty | State |
|---|---|---|
| Anesthesiology, Interventional Pain Management | MI | |
| - | FL | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| A N E S T H E S I O L O G Y | MI | |
| - | AR | |
| Certified Registered Nurse Anesthetist (Crna) | MI | |
| - | MI | |
| Certified Registered Nurse Anesthetist (Crna) | MI |
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