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CHAD RYAN BOUTERSE D.O. NPI 1699896167


NPI Information

NPI: 1699896167
Provider Name: CHAD RYAN BOUTERSE, D.O.
Classification: Ophthalmology - 207W00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
500 PORT DR
CLARKSTON, WA
ZIP 99403
Phone: (509) 758-8811
Get Directions

Chad Ryan Bouterse, D.O. is an ophthalmology in Clarkston, WA with 19 years of experience. The provider is an ophthalmologist has the knowledge and professional skills needed to provide comprehensive eye and vision care. Ophthalmologists are medically trained to diagnose, monitor and medically or surgically treat all ocular and visual disorders. This includes problems affecting the eye and its component structures, the eyelids, the orbit and the visual pathways. In so doing, an ophthalmologist prescribes vision services, including glasses and contact lenses. Chad Ryan Bouterse, D.O. NPI is 1699896167. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: MICHIGAN STATE UNIVERSITY COLLEGE OF OSTEOPATHIC MEDICINE
Graduation Year:2005

The provider's business location address is:

500 PORT DR
CLARKSTON, WA
ZIP 99403-835
Phone: (509) 758-8811
Fax: (509) 751-1188

The NPI 1699896167 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Eye and medical examination for diagnosis and treatment, established patient, 1 or more visits (HCPCS:92014)
  • Eye and medical examination for diagnosis and treatment, established patient (HCPCS:92012)
  • Diagnostic imaging of retina (HCPCS:92134)
  • Diagnostic imaging of optic nerve of eye (HCPCS:92133)
  • Eye and medical examination for diagnosis and treatment, new patient, 1 or more visits (HCPCS:92004)
  • Photography of the retina (HCPCS:92250)

The enumeration date for this NPI number is 4/3/2007 and was last updated on 5/28/2010.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207W00000XOphthalmologyO 570IDAHONo
2207W00000XOphthalmology5101016467MICHIGANNo
3207W00000XOphthalmologyOP60127012WASHINGTONYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1808567100OTHERIDAHOMEDICAID - CLARKSTON
2G8889153MEDICARE PINWASHINGTON
30081BOOTHERASURIS - PULLMAN
41699896167OTHERBLUE CROSS OF IDAHO
5808567101OTHERIDAHOMEDICAID - PULLMAN
60080BOOTHERASURIS - CLARKSTON
71699896167OTHERFEDERAL BLUE CROSS
8258958OTHERWASHINGTONWASHINGTON LABOR & INDUSTRY
91699896167OTHERREGENCE BLUE SHIELD
10O 0570OTHERIDAHOSTATE LICENSE
118564387MEDICAIDWASHINGTON
121699896167OTHERPREMERA BLUE CROSS
13OP60127012OTHERWASHINGTONSTATE LICENSE

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.