DR. MOUNIR BOUTROS (MD) – Dermatology Physician, NPI 1235105941

DR. MOUNIR BOUTROS (MD) is a healthcare provider. based in Toledo, Ohio. specializing in DERMATOLOGY. They hold the professional credentials MD. They hold a License No. 35062133B (OH). The NPI Number for DR. MOUNIR BOUTROS (MD) is 1235105941

Main info

Male
Sole Proprietor
40 Years Of Experience
Accepts Medicare Assignment
Name
DR. MOUNIR BOUTROS (MD)
NPI
1235105941
Phone
(419) 824-2288
Address
5951 RENAISSANCE PL
Enumeration Date
23 February 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
4198242288
Graduation Year
1986 (40 years ago)
PAC ID
2961571427
Group Practice PAC ID
2860561321
Professional Enrollment ID
I20080523000258
Address ID
OH436234722TO5951XPLXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

607 DERMATOLOGY in OH

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Provider Addresses for DR. MOUNIR BOUTROS (MD)

  • Renaissance Toledo Downtown Hotel, 444, CitiWalk - Green Concourse, Saint Clair Street Historic District, Toledo, Lucas County, Ohio, 43604, United States

    SUITE C

    TOLEDO, OH 436234722

    Phone: (419) 824-2288

    Fax: (419) 824-2287

    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)

CMS reports 244 Open Payments records for all available years, with a total value of $5,286.

Total Amount is formed as General ($5,286) + Research ($0) + Ownership ($0) = $5,286.

Last reported payment date: 2024-12-18 • Largest payer in this snapshot: ABBVIE INC. ($1,015).

Total Amount

$5,286

General + Research + Ownership

Payments

244

Total payment records

General Amount

$5,286

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-18

Latest reported date

Top Companies

Largest payers in this snapshot

View all Open Payments →|Open Payments Risk Radar →

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: 2008-05-23

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
I20080523000258IDermatologyOHTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
17003Destruction of precancer skin growth, 2-14 growths2,633403$0
17110Destruction of skin growth, 1-14 growths912583$0
99214Established patient office or other outpatient visit, 30-39 minutes798584$0
17000Destruction of precancer skin growth, 1 growth762482$0
99213Established patient office or other outpatient visit, 20-29 minutes294199$0
View full utilization report →

Insurance plans in this area (ZIP 43623)

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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: 2860561321View full group profile
NameSpecialtyState
Physician AssistantOH

Reviews

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Frequently asked questions

What is the registry number for DR. MOUNIR BOUTROS (MD)?
The registry entry for DR. MOUNIR BOUTROS (MD) shows NPI 1235105941.
Is DR. MOUNIR BOUTROS (MD)'s NPI status active today?
Active status means DR. MOUNIR BOUTROS (MD)'s NPI record is not deactivated in the public file.
How should patients interpret DR. MOUNIR BOUTROS (MD)'s specialty?
The extract shows Dermatology Physician for DR. MOUNIR BOUTROS (MD). Clinical services aligned with this taxonomy classification.
What geographic area is tied to DR. MOUNIR BOUTROS (MD)?
DR. MOUNIR BOUTROS (MD) is associated with Toledo, Ohio in the same public data insurers reference.
Can I export DR. MOUNIR BOUTROS (MD)'s record?
You can download the official NPPES record; we summarize key fields for readability.

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