Individual ProviderEkaterini BoutosNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2015 Grand Concourse, Bronx, NY 10453-4303(718) 299-7295(718) 618-0401PECOS EnrollmentBased on the most recent information from CMS, provider Ekaterini Boutos is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1255733192Provider TypeIndividualFull NameBoutos, EkateriniCredentialRN, FNPGenderFemaleSole ProprietorNoEnumeration Date9/23/2014Last Updated3/24/2016Contact InformationPractice LocationPractice Address2015 Grand Concourse, Bronx, NY 10453-4303Phone(718) 299-7295Fax(718) 299-6797Mailing LocationMailing Address3198 Grand Concourse, Bronx, NY 10458-1000Phone(718) 618-0401Fax(718) 795-4394Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense339182New York