Individual provider Active NPI

Michelle M. Bouyea, M.D.

  • Anesthesiology Physician
  • Willingboro, NJ
National Provider Identifier
1124001797
Registry record updated Jan 16, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
25MA07317700 Issued in NJ
Practice address
1000 Salem Rd
Suite B
Willingboro, NJ 08046-2852
Phone
(877) 476-6642
Fax
(914) 819-0061
NPI assigned
Nov 28, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X 25MA07317700 NJ Primary

Addresses

Primary practice location

1000 Salem Rd
Suite B
Willingboro, NJ 08046-2852

Mailing address

725 River Rd
#299
Edgewater, NJ 07020-1171
Phone (877) 476-6642

Other identifiers 2

IdentifierTypeStateIssuer
8739901MedicaidNJ
P00953298OtherNJRR MCR PTAN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20040616000282 NJ Practitioner - Anesthesiology 8224012380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Albany Medical College of Union University, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Allied Digestive Health LLCGroup PAC ID 5991027583, 282 clinicians

Practice addresses (Care Compare)

1907 State Route 35 9
Oakhurst, NJ 07755-2760
Phone (732) 312-5580

Merit-based Incentive Payment System (MIPS)

Final score
98.3 of 100Reported as group
Promoting interoperability
98
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
25MA07317700NJMDAnesthesiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Allied Digestive Health, LLC Anesthesiology CurrentSince Dec 1, 2021 Accepting new patients
Atlantic Coast Gastroenterology Associates Past Accepting new patients
Anesthesiology Associates of Eastern Connecticut, P.C Anesthesiology Past Accepting new patients

Locations

901 W Main St
Freehold, NJ 07728
Phone (732) 294-2666

1945 Corlies Ave
Neptune City, NJ 07753
Phone (732) 776-4203

1907 Highway 35
Ste 9
Oakhurst, NJ 07755
Phone (732) 517-0060

1907 State Route 35
Ste 1
Oakhurst, NJ 07755
Phone (732) 517-0060

1640 Route 88 W
Ste 202
Wall Township, NJ 08724
Phone (732) 370-2220

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1133136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642291200000",
    "number": "1124001797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 RIVER RD",
            "address_2": "#299",
            "city": "EDGEWATER",
            "state": "NJ",
            "postal_code": "070201171",
            "telephone_number": "877-476-6642",
            "fax_number": "914-819-0061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 SALEM RD",
            "address_2": "SUITE B",
            "city": "WILLINGBORO",
            "state": "NJ",
            "postal_code": "080462852",
            "telephone_number": "877-476-6642",
            "fax_number": "914-819-0061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUYEA",
        "first_name": "MICHELLE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-28",
        "last_updated": "2022-01-16",
        "certification_date": "2022-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NJ",
            "license": "25MA07317700",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8739901",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR PTAN",
            "identifier": "P00953298",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Willingboro, NJ

Sources for this page

Verify at the official NPI Registry.