Dr Mark Samir Boutros, MD - Medicare Internal Medicine in Indianapolis, IN

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Dr Mark Samir Boutros, MD is a medicare enrolled "Internal Medicine" physician in Indianapolis, Indiana. He graduated from medical school in 2005 and has 21 years of diverse experience with area of expertise as Internal Medicine. He is a member of the group practice Rural Physicians Group-pannu Pllc, Lake Spring Physician Services, Llc and his current practice location is 4200 S East St, Indianapolis, Indiana. You can reach out to his office (for appointments etc.) via phone at (317) 991-7600.

Dr Mark Samir Boutros is licensed to practice in Virginia (license number 0101265722) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1700992674.

Contact Information

Dr Mark Samir Boutros, MD
4200 S East St,
Indianapolis, IN 46227
(317) 991-7600
(317) 215-7038

Map and Direction




Physician's Profile

Full NameDr Mark Samir Boutros
GenderMale
SpecialityInternal Medicine
Experience21 Years
Location4200 S East St, Indianapolis, Indiana
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Dr Mark Samir Boutros graduated from medical school in 2005
  NPI Data:
  • NPI Number: 1700992674
  • Provider Enumeration Date: 08/22/2006
  • Last Update Date: 07/23/2026
  Medicare PECOS Information:
  • PECOS PAC ID: 6800080334
  • Enrollment ID: I20260202003557

Medical Identifiers

Medical identifiers for Dr Mark Samir Boutros such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1700992674NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
207R00000XInternal Medicine 01070720A (Indiana)Secondary
207R00000XInternal Medicine 247040 (Tennessee)Secondary
207R00000XInternal Medicine 0101265722 (Virginia)Primary
207R00000XInternal Medicine 88883 (South Carolina)Secondary

Medical Facilities Affiliation

Facility NameLocationFacility Type
Lewisgale Medical CenterSalem, VAHospital
Allendale County HospitalFairfax, SCHospital
Allendale County HospitalFairfax, SCNursing home

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Rural Physicians Group-pannu Pllc0345467486141
Lake Spring Physician Services, Llc125468948289

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Mark Samir Boutros allows following entities to bill medicare on his behalf.
Entity NameRural Physicians Group-pannu PLLC
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1891236584
PECOS PAC ID: 0345467486
Enrollment ID: O20230711001944

Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Mark Samir Boutros is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Dr Mark Samir Boutros, MD
4200 S East St,
Indianapolis, IN 46227-1534

Ph: (317) 991-7600		Dr Mark Samir Boutros, MD
4200 S East St,
Indianapolis, IN 46227

Ph: (317) 991-7600

Reviews and Comments


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Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.