NPIMap

Individual provider Active NPI

Mark P. Bouchard, MD

  • Family Medicine Physician
  • Falmouth, ME
National Provider Identifier
1023040656
Registry record updated Apr 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD14613 Issued in ME
Practice address
5 Bucknam Rd
Suite 2C
Falmouth, ME 04105-1392
Phone
(207) 781-1500
Fax
(207) 781-1507
NPI assigned
Jul 6, 2006
Last updated
Apr 9, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 9, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Medicine (Family Medicine) Physician 207QS0010X MD14613 ME
Hospitalist Physician 208M00000X MD14613 ME
Family Medicine Physician 207Q00000X MD14613 ME Primary

Addresses

Primary practice location

5 Bucknam Rd
Suite 2C
Falmouth, ME 04105-1392

Mailing address

301C US Route 1
Scarborough, ME 04074-9701
Phone (207) 396-8600

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in ME
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040819001113 ME Practitioner - Family PracticePractitioner - Sports Medicine 2567436264 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Sports Medicine
Education
University of Vermont College of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MainehealthGroup PAC ID 7517860588, shared by 31 NPIs, 2,616 clinicians

Practice addresses (Care Compare)

22 Bramhall St
Portland, ME 04102-3134
Phone (207) 885-9905

272 Congress St
Portland, ME 04101-3637
Phone (207) 874-2466

5 Bucknam Rd
Falmouth, ME 04105-1209

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD14613MEMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mainehealth CurrentSince Feb 11, 1998 Accepting new patients
Maine Medical Partners Current Accepting new patients
Maine Medical Partners CurrentSince May 6, 2013 Accepting new patients
Maine Medical Partners Family Medicine CurrentSince Aug 5, 2018 Accepting new patients
Maine Medical Partners Current Accepting new patients
Mainehealth Family Medicine CurrentSince Aug 1, 1999 Accepting new patients
Mainehealth CurrentSince Feb 11, 1998 Accepting new patients
Maine Medical Partners CurrentSince May 6, 2013 Accepting new patients
Mainehealth Current Accepting new patients
Maine Medical Partners Hospitalist CurrentSince Jun 1, 2015 Accepting new patients
Mainehealth Family Medicine Past Accepting new patients
Mainehealth Past Accepting new patients

Locations

22 Bramhall St
Portland, ME 04102
Phone (207) 662-2179

272 Congress St
Portland, ME 04101
Phone (207) 874-2466

5 Bucknam Rd
Ste 2B
Portland, ME 04105
Phone (207) 781-1600

5 Bucknam Rd
Ste 2C
Portland, ME 04105
Phone (207) 781-1500

100 Campus Dr
Unit 107
Scarborough, ME 04074
Phone (207) 396-7565

301C US Route 1
Scarborough, ME 04074
Phone (207) 396-8600

96 Campus Dr
Ste 2B
Scarborough, ME 04074
Phone (207) 883-3491

39 Wallace Ave
South Portland, ME 04106
Phone (207) 761-0650

1 Harnois Ave
Ste 1A
Westbrook, ME 04092
Phone (207) 662-1360

1 Harnois Ave
Ste 2
Westbrook, ME 04092
Phone (207) 661-3400

584 Roosevelt Trl
Windham, ME 04062
Phone (207) 892-3216

Interoperability endpoints

  • Direct secure messaging: mbouchard593@direct.mmc.mainehealth.org

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 42

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 42

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1152144000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586390400000",
    "number": "1023040656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301C US ROUTE 1",
            "city": "SCARBOROUGH",
            "state": "ME",
            "postal_code": "040749701",
            "telephone_number": "207-396-8600",
            "fax_number": "207-396-8632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BUCKNAM RD",
            "address_2": "SUITE 2C",
            "city": "FALMOUTH",
            "state": "ME",
            "postal_code": "041051392",
            "telephone_number": "207-781-1500",
            "fax_number": "207-781-1507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "MARK",
        "middle_name": "P.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-06",
        "last_updated": "2020-04-09",
        "certification_date": "2020-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "ME",
            "license": "MD14613",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "ME",
            "license": "MD14613",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "ME",
            "license": "MD14613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Falmouth, ME

Sources for this page

Verify at the official NPI Registry.