Reid Elliot Bouchard, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT40403 Issued in CA

Practice address

1958 Via Ctr
Vista, CA 92081-6056

Phone

(760) 724-9000

Fax

(760) 724-3686

NPI assigned

Sep 26, 2013

Last updated

Aug 19, 2021By 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

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Creighton University School of Medicine, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Tri-City Orthopaedic Surgery Medical Group Inc.Group PAC ID 1153388434, 24 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: rbouchard81430@scrippshlth.medalliesdirect.net

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.

• Tri-City Orthopaedic Surgery Medical Group Inc

  dba Orthopaedic Specialists of North County, Inc

  • Orthopaedic Surgery Physician
  • Oceanside, CA
  • NPI 1861451445

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Scripps Health

  dba Scripps Hospital Medical Services

  • General Acute Care Hospital
  • San Diego, CA
  • NPI 1487928891
  NPD
• Tri City Orthopaedic Surgery Medical Group Inc

  dba Orthopaedic Specialists of North County Inc

  • Orthopedic Physical Therapist
  • Vista, CA
  • NPI 1912314303
  NPD
• Tri-City Orthopaedic Surgery Medical Group Inc

  dba Orthopaedic Specialists of North County

  • Orthopaedic Surgery Physician
  • Oceanside, CA
  • NPI 1659797231

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1380153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629331200000",
    "number": "1104253855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3905 WARING RD",
            "city": "OCEANSIDE",
            "state": "CA",
            "postal_code": "920564405",
            "telephone_number": "760-724-9000",
            "fax_number": "760-724-3686"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1958 VIA CTR",
            "city": "VISTA",
            "state": "CA",
            "postal_code": "920816056",
            "telephone_number": "760-724-9000",
            "fax_number": "760-724-3686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "REID",
        "middle_name": "ELLIOT",
        "name_prefix": "Mr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-09-26",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT40403",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michael Alexander Booth, MFT
• Enrique M. Boquin, M.D.
• Kelly Bordman, LCSW
• Kathleen Ann Borgeson, LCSW
• Jazmyne Arteese Bosley, NP
• Hilary Mara Bowers, MD
• Caleb S Bradford
• Bradley a. Eli Dental Corporation
• Bradley W Greider MD Inc
• Raymond Bradley, RN

• Physical Therapist in Vista, CA
• Providers in Vista, CA by specialty
• Physical Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.