Michelle Boutin, PA

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

Practice address

15 Gracelawn Rd Ste 101
Auburn, ME 04210-6347

Phone

(207) 333-4710

Fax

(207) 333-4715

NPI assigned

Jan 6, 2021

Last updated

Nov 8, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St Marys Regional Medical CenterGroup PAC ID 0042107120, 192 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary's Regional Medical Center Hospital, Lewiston, ME, CCN 200034

Merit-based Incentive Payment System (MIPS)

Final score

97.93 of 100Reported as apm

Quality

83.31

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

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.

• St. Mary's Regional Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1447226584
  Medicare reassignment Care Compare group NPD

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

• St. Mary's Regional Medical Center

  • General Acute Care Hospital
  • Lewiston, ME
  • NPI 1447226584
  Care Compare affiliation

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

{
    "created_epoch": "1609891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667865600000",
    "number": "1194313080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 95000 LBX 7650",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191950001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 GRACELAWN RD STE 101",
            "city": "AUBURN",
            "state": "ME",
            "postal_code": "042106347",
            "telephone_number": "207-333-4710",
            "fax_number": "207-333-4715"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "773 Main St",
            "address_purpose": "LOCATION",
            "city": "Hartford",
            "state": "ME",
            "postal_code": "042205120",
            "country_code": "US",
            "telephone_number": "207-212-4119",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUTIN",
        "first_name": "MICHELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-06",
        "last_updated": "2022-11-08",
        "certification_date": "2022-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mboutin1203554@direct.bsmhealth.org",
            "affiliation": "Y",
            "affiliationName": "St. Mary's Regional Medical Center",
            "address_1": "15 Gracelawn Rd Ste 101",
            "city": "Auburn",
            "state": "ME",
            "country_code": "US",
            "postal_code": "042106347",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Tyler Boilard, PHARMD
• Amy Borens, RDH
• Holly Frey Bosse, FNP-C
• Lisa Jean Boucher, P.A.-C
• Mary Ann Boulos-Lord, NP
• Laura Kathryn Bradbury, LCSW
• Courtney Karol Bradeen, LCSW
• Robert Henry Brainerd Jr., LATC, CSCS
• Douglas W Breunig, LCSW
• Kristen Brewer, HIS

• Surgical Physician Assistant in Auburn, ME
• Providers in Auburn, ME by specialty
• Surgical Physician Assistant in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2022; 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.