Deactivated NPI 1508847807 Deactivated / Inactive NPI Male Practitioner

Dr. Peter S Boutsicaris , MD

Surgery • Canton, OH

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Dr. Peter Boutsicaris has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 14, 2005

NPI Deactivation Date December 28, 2022

Total Practice Duration ~17 Years of Practice (2005 – 2022)

Professional Overview & Biography Verified Profile Summary

Dr. Peter Boutsicaris, MD was a registered Surgery practicing in Canton, OH. Throughout an active medical career spanning 17 years, Dr. Boutsicaris provided care at the practice location at 1330 MERCY DR NW until profile deactivation on 2022-12-28.

Historical Medicare Part B clinical services included follow-up hospital inpatient care per day, established patient outpatient office visit, initial hospital care with straightforward or low-level medical decision making, if using time, at least. Public procedure reimbursement records and service volume details are provided below for historical transparency.

Practice Location & Contact Primary Location

Practice Address

1330 Mercy Dr Nw
Suite 319

Canton, OH 447082626

Telephone 3305804706

Fax 3305804707

Associated Practice Facility / Clinic

🏢 Tsa Thoracic Surgical Associates Inc Facility NPI 1275520348

Specialty Benchmarks & Practice Insights

Comparative analytics for Surgery in Canton, OH

Active Practitioner

Practitioner Clinical Experience

Active

City Avg: 21.4 Yrs

State Avg: 24.9 Yrs

Regional Practice Density

25 Specialists

Practicing in Canton, OH (1313 Statewide)

Telehealth Adoption Rate

0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount

31.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Performed Procedures & Service Volume

Top Medicare Part B procedures performed by this practitioner

CMS Official Data (2021)

Reporting Year:

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99231 Follow-up hospital inpatient care per day, typically 15 minutes	40	20	$59.00	$37.67
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	17	$39.00	$35.57
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	12	12	$206.00	$133.49
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$194.00	$134.86

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99231 Follow-up hospital inpatient care per day, typically 15 minutes	40	20	$58.70	$39.55
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	39	24	$107.46	$70.94
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	17	16	$40.59	$26.03
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	13	13	$205.38	$129.50

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	42	23	$105.00	$71.69
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	39	30	$38.82	$25.18
99231 Follow-up hospital inpatient care per day, typically 15 minutes	30	16	$58.00	$38.87
99221 Initial hospital inpatient care per day, typically 30 minutes	28	28	$147.00	$100.13
99202 New patient office or other outpatient visit, typically 20 minutes	19	19	$78.53	$48.18
99203 New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more	13	13	$119.46	$75.28

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99231 Follow-up hospital inpatient care per day, typically 15 minutes	41	15	$58.00	$37.32
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	35	30	$38.00	$24.22
99221 Initial hospital inpatient care per day, typically 30 minutes	17	17	$147.00	$96.48
99202 New patient office or other outpatient visit, typically 20 minutes	12	12	$74.00	$48.02
99204 New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more	11	11	$193.82	$123.06

HCPCS Code & Description	Services	Patients	Submitted Charge	Medicare Allowed
99231 Follow-up hospital inpatient care per day, typically 15 minutes	55	28	$58.00	$37.84
99232 Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes	41	18	$105.00	$67.84
99212 Established patient office or other outpatient visit with straightforward medical decision making, if using time, 10 minutes or more	33	30	$38.64	$24.75
99202 New patient office or other outpatient visit, typically 20 minutes	27	27	$74.00	$49.34
99222 Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes	19	18	$198.00	$128.35

Medical Specialties & State Licenses

Surgery Primary Specialty

NUCC Taxonomy Code: 208600000X

State License OH 35058283B

A general surgeon has expertise related to the diagnosis - preoperative, operative and postoperative management - and management of complications of surgical conditions in the following areas: alimentary tract; abdomen; breast, skin and soft tissue; endocrine system; head and neck surgery; pediatric surgery; surgical critical care; surgical oncology; trauma and burns; and vascular surgery. General surgeons increasingly provide care through the use of minimally invasive and endoscopic techniques. Many general surgeons also possess expertise in transplantation surgery, plastic surgery and cardiothoracic surgery.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

8 Associated Practitioners

Dr. Amy Indorf , MD

Internal Medicine - Infectious Disease

NPI 1033295951

Doctor of Medicine (M.D.)

Dr. Slawomir Fratczak , MD

Internal Medicine

NPI 1124009436

Doctor of Medicine (M.D.)

Dr. Kirby Sweitzer , MD

Surgery

NPI 1154302461

Doctor of Medicine (M.D.)

Abigail Christiansen

Surgery

NPI 1295266211

Dr. Nathan Hieb , MD

Surgery

NPI 1366837361

Doctor of Medicine (M.D.)

Dr. Gregory Boone , MD

Surgery

NPI 1407854516

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

7 Historical Events

⚠️

NPI Profile Deactivated December 28, 2022

Record deactivated on December 28, 2022

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NPI Profile Active February 01, 2010

NPI status registered as active in NPPES database

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Updated Practice Location February 01, 2010

Registered at 1330 MERCY DR NW, SUITE 319, CANTON, OH 447082626 (Tel: 3305804706)

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Updated Business Mailing Address February 01, 2010

Registered at 1330 MERCY DR NW, SUITE 319, CANTON, OH 447082626 (Tel: 3305804706)

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Provider Name / Credentials Updated February 01, 2010

Recorded as PETER BOUTSICARIS, M.D.

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Medical Taxonomy / Specialty Registered (Primary Specialty) February 01, 2010

Surgery (License #35058283B in OH)

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Initial NPI Registration & Enumeration November 14, 2005

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: 1508847807

Entity Type:

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

Enumeration Date: November 14, 2005

Last Update: February 01, 2010

Deactivation Date: December 28, 2022

Update or Correct Profile

Mailing Address

1330 Mercy Dr Nw, Suite 319

Canton, OH 447082626

Phone: 3305804706

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.