Active NPI 1518115948 Individual Practitioner Male Practitioner

Dr. Jay Boughanem , MD

Orthopaedic Surgery • Chicago, IL

✓ Accepts Medicare Assignment Telehealth Available

Professional Overview & Biography Verified Profile Summary

Dr. Jay Boughanem, MD is a certified Orthopaedic Surgery practicing in Chicago, IL. With approximately 21 years of clinical experience since graduating from Northwestern University Feinberg Medical School in 2005, Dr. Boughanem delivers high-quality medical care to the local community at 676 N SAINT CLAIR ST FL 13.

Dr. Boughanem maintains professional affiliations with Banner Churchill Community Hospital, Banner Health Physicians West Llc and accepts Medicare assignment . Telehealth and virtual consultation options are available for eligible patients.

Frequently performed procedures and clinical services include established patient outpatient office visit, new patient outpatient office visit, anchoring of biceps tendon. Full Medicare procedure pricing transparency rates and service volume details are listed on this profile.

Practice Location & Contact Primary Location

Practice Address

676 N Saint Clair St Fl 13
Department Of Orthopaedic Surgery

Chicago, IL 606113060

Telephone 3129264485

Medicare Profile & Education

Medical School

Northwestern University Feinberg Medical School

Graduation Year

2005

Medicare Assignment

✓ Accepts Assignment

Telehealth Flag

Telehealth Services Available

Specialty Benchmarks & Practice Insights

Comparative analytics for Orthopaedic Surgery in Chicago, IL

Senior Veteran Specialist (>20 Yrs)

Practitioner Clinical Experience

21 Yrs -0.6 yrs vs City Avg

City Avg: 21.6 Yrs

State Avg: 27.0 Yrs

Regional Practice Density

290 Specialists

Practicing in Chicago, IL (1064 Statewide)

Telehealth Adoption Rate

5.5% Regional Adoption

✓ Offers Virtual Consultations

Medicare Pricing Discount

81.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Clinical Seniority & Experience Comparison

Dr. Boughanem (21 Years) 21 Yrs

Chicago Specialty Average (21.6 Years) 21.6 Yrs

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2024)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	163	106	$401.94	$126.79
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	146	96	$501.85	$183.14
99205 New patient office or other outpatient visit with a high level of medical decision making, if using time, 60 minutes or more	41	41	$600.61	$225.94
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	41	41	$505.08	$157.48
23430 Anchoring of biceps tendon	32	32	$3007.81	$355.53
29827 Repair of shoulder rotator cuff using an endoscope	29	28	$2111.05	$971.58
29824 Partial removal of collar bone at shoulder using an endoscope	28	28	$2036.04	$196.68
29823 Removal of extensive shoulder joint tissue using an endoscope	28	27	$3008.93	$113.68
29826 Shaving of part of shoulder bone and repair of ligament using an endoscope	27	27	$403.39	$154.33
23440 Transplantation of biceps tendon	18	18	$3000.00	$364.59
99213 Established patient office or other outpatient visit, typically 15 minutes	17	15	$300.00	$89.77
20611 Aspiration and/or injection of fluid large joint using ultrasound guidance	15	11	$400.00	$88.89

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	207	99	$415.50	$130.02
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	80	80	$515.98	$168.05
99213 Established patient office or other outpatient visit, typically 15 minutes	32	27	$263.52	$91.12
23430 Anchoring of biceps tendon	11	11	$3124.98	$387.07

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	79	53	$394.67	$134.42
99213 Established patient office or other outpatient visit, typically 15 minutes	69	48	$217.09	$90.24
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	50	50	$489.35	$171.77
99221 Initial hospital inpatient care per day, typically 30 minutes	20	20	$405.00	$92.94
99215 Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more	16	14	$520.83	$192.40

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	38	27	$143.59	$89.55
99221 Initial hospital inpatient care per day, typically 30 minutes	23	22	$405.00	$94.89
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	15	11	$190.68	$137.04
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	14	14	$257.63	$167.74

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99213 Established patient office or other outpatient visit, typically 15 minutes	29	28	$136.45	$79.18
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	17	17	$202.00	$109.61
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$202.00	$114.81
27447 Replacement of knee joint, both sides of knee	12	12	$2501.00	$1415.08

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	102	24	$60.00	$1.78
99213 Established patient office or other outpatient visit, typically 15 minutes	93	82	$138.00	$77.47
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	39	34	$202.00	$113.82
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	38	38	$305.16	$168.93
20610 Aspiration and/or injection of fluid from large joint	31	23	$113.00	$57.20
27447 Replacement of knee joint, both sides of knee	27	26	$2500.37	$1432.52
99213 Established patient office or other outpatient visit, typically 15 minutes	12	12	$138.00	$52.57
23430 Anchoring of biceps tendon	12	12	$1388.00	$390.17

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
J3301 Injection, triamcinolone acetonide, not otherwise specified, 10 mg	164	34	$60.00	$1.80
99213 Established patient office or other outpatient visit, typically 15 minutes	115	95	$124.99	$76.24
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	59	59	$184.10	$113.83
20610 Aspiration and/or injection of fluid from large joint	34	27	$125.30	$57.97
99214 Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more	34	31	$183.06	$113.53
27447 Replacement of knee joint, both sides of knee	30	28	$2763.03	$1449.71
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	15	15	$280.73	$171.46

Medical Specialties & State Licenses

CMS Verified: 2023-07-11

Orthopaedic Surgery Primary Specialty

NUCC Taxonomy Code: 207X00000X

State License IL 036120773

An orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system.

Orthopaedic Surgery

NUCC Taxonomy Code: 207X00000X

State License WI 73259-20

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID

1518115948 (WI)

Hospital & Practice Group Affiliations

Banner Churchill Community Hospital

801 E Williams Ave, Fallon, NV 894063052

Banner Churchill Community Hospital

801 E Williams Ave, Fallon, NV 894063052

Phone: 7758677701

Banner Health Physicians West Llc

801 E Williams Ave, Fallon, NV 894063052

Phone: 7754233151

Secondary Practice Locations

1626 Tuttle St

Baraboo, WI 539131501

Phone: 6083556868

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) July 11, 2023

Orthopaedic Surgery (License #73259-20 in WI)

✅

NPI Profile Active August 27, 2008

NPI status registered as active in NPPES database

📍

Updated Practice Location August 27, 2008

Registered at 676 N SAINT CLAIR ST FL 13, DEPARTMENT OF ORTHOPAEDIC SURGERY, CHICAGO, IL 606113060 (Tel: 3129264485)

📍

Updated Business Mailing Address August 27, 2008

Registered at 2718 N WILTON AVE, UNIT 2, CHICAGO, IL 606142875 (Tel: 3123711861)

👤

Provider Name / Credentials Updated August 27, 2008

Recorded as JAY BOUGHANEM, MD

🎓

Medical Taxonomy / Specialty Registered (Primary Specialty) August 27, 2008

Orthopaedic Surgery (License #036120773 in IL)

🟢

Initial NPI Registration & Enumeration August 27, 2008

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1518115948

Entity Type:

Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)

Enumeration Date: August 27, 2008

Last Update: July 11, 2023

Sole Proprietor: No

Update or Correct Profile

Mailing Address

2718 N Wilton Ave, Unit 2

Chicago, IL 606142875

Phone: 3123711861

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).

⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.