Jose Antonio Bouffard, M.D.

Primary specialty

Nuclear Imaging & Therapy PhysicianTaxonomy code 207UN0902X

License

4301044748 Issued in MI

Practice address

261 Mack Ave
Room 215
Detroit, MI 48201-2417

Phone

(313) 966-2539

Fax

(313) 993-2630

NPI assigned

Dec 1, 2006

Last updated

Sep 8, 2014By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• J Antonio Bouffard Professional name

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Diagnostic Radiology

Education

Other, 1980

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Basha Diagnostics P CGroup PAC ID 5890681746, 28 clinicians

VHS Physicians of MichiganGroup PAC ID 8921289760, 219 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Huron Valley-Sinai Hospital Hospital, Commerce Township, MI, CCN 230277

Merit-based Incentive Payment System (MIPS)

Final score

90.26 of 100Reported as group

Quality

64.16

Promoting interoperability

100

Improvement activities

40

Cost

73.79

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jabouffar@direct.dmc.org

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.

• Basha Diagnostics P C

  • Diagnostic Radiology Physician
  • Royal Oak, MI
  • NPI 1770693798
  Medicare reassignment Care Compare group NPD
• VHS Physicians of Michigan

  dba DMC Medical Group

  • Internal Medicine Physician
  • Southfield, MI
  • NPI 1073827101
  Medicare reassignment Care Compare group NPD
• Radadvantage a Professional Corporation

  • Diagnostic Radiology Physician
  • Phoenix, AZ
  • NPI 1376719666

  MI

  Medicare reassignment NPD

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

• VHS Huron Valley-Sinai Hospital Inc

  dba Huron Valley-Sinai Hospital

  • General Acute Care Hospital
  • Commerce Township, MI
  • NPI 1922310200
  Care Compare affiliation

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

{
    "created_epoch": "1164931200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1043388788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "261 MACK AVE",
            "address_2": "ROOM 215",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012417",
            "telephone_number": "313-966-2539",
            "fax_number": "313-993-2630"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 MACK AVE",
            "address_2": "ROOM 215",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482012417",
            "telephone_number": "313-966-2539",
            "fax_number": "313-993-2630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUFFARD",
        "first_name": "JOSE",
        "middle_name": "ANTONIO",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-01",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207UN0902X",
            "taxonomy_group": "",
            "desc": "Nuclear Medicine, Nuclear Imaging & Therapy",
            "state": "MI",
            "license": "4301044748",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "JB044748",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "J",
            "last_name": "BOUFFARD",
            "middle_name": "ANTONIO",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Mark Steven Bott, RN
• Ralphe Bou Chebl, M.D.
• Alison Tisack Boucher, M.D.
• Cindy Neka Boudreaux, MD
• Renee Bouey, PH.D.
• Shelly Lauren Bouie, RN
• Spyridon Boukouris, M.D.
• Jamila B Boulaalam, DDS
• Asmaa Boulehia
• Boulevard Manor L.L.C.

• Nuclear Medicine Physician in Detroit, MI
• Providers in Detroit, MI by specialty
• Nuclear Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.