Latifa Boukarrou, MD

Primary specialty

Neurology PhysicianTaxonomy code 2084N0400X

License

A156992 Issued in CA

Practice address

1651 SE Tiffany Ave
Suite 101
Port Saint Lucie, FL 34952-7564

Phone

(772) 419-3810

Fax

(772) 419-3811

NPI assigned

Apr 30, 2010

Last updated

May 14, 2025By 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 5

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in CA, WI2 enrollments

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 2

Specialty

Neurology

Education

Other, 2000

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Cep America - Neurology PCGroup PAC ID 3971871500, 60 clinicians

Emergency and Acute Care Medical CorporationGroup PAC ID 9537108279, 431 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Networks

• BSC 65 PLUS INDIVIDUAL MAPD

Interoperability endpoints

• Direct secure messaging: lboukarrou575203@hisp.ehr.sutterhealth.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.

• Cep America - Neurology PC

  dba Vituity

  • Neurology Physician
  • Santa Barbara, CA
  • NPI 1225569346
  Medicare reassignment Care Compare group NPD
• Emergency and Acute Care Medical Corporation

  • Emergency Medicine Physician
  • San Diego, CA
  • NPI 1437103942
  Medicare reassignment Care Compare group NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Internal Medicine Physician
  • Menomonee Falls, WI
  • NPI 1568787448
  Medicare reassignment NPD
• Thedacare, Incorporated

  dba ThedaCare Physicians

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959

  CA

  Medicare reassignment NPD
• Access Telecare California, P.C.

  • Neurology Physician
  • Dallas, TX
  • NPI 1861959959

  CA

  Medicare reassignment
• Cep America - Neurology PC

  • Neurology Physician
  • Saint Johns, FL
  • NPI 1164109328
  NPD
• Cep America - Neurology PC

  • Neurology Physician
  • Terre Haute, IN
  • NPI 1124843586
  NPD
• Froedtert &the Medical College of Wisconsin Community Physicians, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Wauwatosa, WI
  • NPI 1154947224
  NPD
• Neurological Institute of Los Angeles

  • Neurology Physician
  • Beverly Hills, CA
  • NPI 1659849040
  NPD

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

{
    "created_epoch": "1272585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1366769317",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 417",
            "city": "STUART",
            "state": "FL",
            "postal_code": "349950417",
            "telephone_number": "772-223-2832",
            "fax_number": "772-223-5646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 SE TIFFANY AVE",
            "address_2": "SUITE 101",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349527564",
            "telephone_number": "772-419-3810",
            "fax_number": "772-419-3811"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 2nd St",
            "address_purpose": "LOCATION",
            "city": "Neenah",
            "state": "WI",
            "postal_code": "549562883",
            "country_code": "US",
            "telephone_number": "920-735-7645",
            "fax_number": "920-735-7618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUKARROU",
        "first_name": "LATIFA",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-30",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WA",
            "license": "MD61603092",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "PA",
            "license": "MD449015",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "WI",
            "license": "84996",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "FL",
            "license": "ME129352",
            "primary": false
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": "CA",
            "license": "A156992",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FLORIDA BLUE",
            "identifier": "TP618",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/scalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "Southern California Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "9961 Sierra Ave",
            "city": "Fontana",
            "state": "CA",
            "country_code": "US",
            "postal_code": "923356720",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Eduardo F Borges, MD
• Artem Borisov
• Sean Borman
• Morgan Frances Bos, MMS, PA-C
• Maureen Bosco, CRNA
• Boulevard Dental Associates
• Catherine Bova, PHARMD
• Hannah Tai Bowen
• Paul Bower, M.D.
• Kayla Bowser, RD

• Neurology Physician in Port Saint Lucie, FL
• Providers in Port Saint Lucie, FL by specialty
• Neurology Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 14, 2025; 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.