Michael S Bouton, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

10920 Issued in ND

Practice address

801 Broadway N
Fargo, ND 58102-3641

Phone

(701) 234-2251

Fax

(701) 234-2050

NPI assigned

Sep 15, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Merit-based Incentive Payment System (MIPS)

Final score

82.73 of 100Reported as group

Quality

71.75

Promoting interoperability

100

Improvement activities

40

Cost

70.68

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Sparks Medical Foundation

  • Durable Medical Equipment & Medical Supplies
  • Fort Smith, AR
  • NPI 1033219449
  NPD (past)

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

{
    "created_epoch": "1126742400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1648166400000",
    "number": "1356336358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2010",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581220605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 BROADWAY N",
            "city": "FARGO",
            "state": "ND",
            "postal_code": "581023641",
            "telephone_number": "701-234-2251",
            "fax_number": "701-234-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTON",
        "first_name": "MICHAEL",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-15",
        "last_updated": "2022-03-25",
        "certification_date": "2022-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "AR",
            "license": "R4107",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TX",
            "license": "G9329",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "ND",
            "license": "10920",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "14800",
            "state": "ND"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mbouton1841436@direct.sanfordhealth.org",
            "affiliation": "N",
            "address_1": "801 Broadway N",
            "city": "Fargo",
            "state": "ND",
            "country_code": "US",
            "postal_code": "581023641",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Emma Botker, PT, DPT
• Brandon Botner
• Megan Kristine Boucher, MA, OTR/L
• Nicole Renae Boucher, SLP
• Tanner Boutain
• Ann T Boutwell, RN
• Megan Bowen, MD
• Tara Bowen, RN
• Jocelyn Bowker, MD
• Weston Eugene Bowker, MD

• Surgery Physician in Fargo, ND
• Providers in Fargo, ND by specialty
• Surgery Physician in North Dakota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.