Michael D Boucher, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

026903 Issued in NY

Practice address

3808 14TH Ave
Brooklyn, NY 11218-3610

Phone

(718) 972-2424

NPI assigned

Feb 11, 2014

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

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in CA, NY2 enrollments

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 2

Specialty

Physician Assistant

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Maimonides Faculty Practice PlanGroup PAC ID 7012808348, 251 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Maimonides Medical Center Hospital, Brooklyn, NY, CCN 330194

Merit-based Incentive Payment System (MIPS)

Final score

86.33 of 100Reported as group

Quality

82.1

Promoting interoperability

100

Improvement activities

40

Cost

72.34

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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 and National Provider Directory roles.

• Maimonides Faculty Practice Plan

  • Internal Medicine Physician
  • Brooklyn, NY
  • NPI 1053344846
  Medicare reassignment Care Compare group
• Signify Health Medical Associates of California, PC

  • General Practice Physician
  • San Francisco, CA
  • NPI 1124685169
  Medicare reassignment NPD
• BP Immediate Medical Care, PC

  • Urgent Care Clinic/Center
  • Brooklyn, NY
  • NPI 1205105004
  Medicare reassignment
• Temecula Valley Emergency Medical Associates

  • Specialist
  • Murrieta, CA
  • NPI 1407845092
  Medicare reassignment
• Inland Urgent Care a Medical Corporation

  • Urgent Care Clinic/Center
  • Corona, CA
  • NPI 1013369321
  NPD
• Pharma Holding Inc

  • Pharmacy
  • Brooklyn, NY
  • NPI 1396153680
  NPD (past)
• Rockland Medical Group, PLLC

  • Internal Medicine Physician
  • Garnerville, NY
  • NPI 1336172501
  NPD (past)
• Keystone Medical Urgent Care, LLC

  • Urgent Care Clinic/Center
  • Warminster, PA
  • NPI 1235553496
  NPD (past)

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

• Maimonides Medical Center

  • General Acute Care Hospital
  • Brooklyn, NY
  • NPI 1093777492
  Care Compare affiliation

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

{
    "created_epoch": "1392076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724198400000",
    "number": "1386068310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 FRANKLIN AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112052728",
            "telephone_number": "212-257-2424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3808 14TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112183610",
            "telephone_number": "718-972-2424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "MICHAEL",
        "middle_name": "D",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-02-11",
        "last_updated": "2024-08-21",
        "certification_date": "2024-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NY",
            "license": "026903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P01718733",
            "state": "NV"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1386068310",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jeffrey Bouchard-Burns, MD
• Courtney Bouchard
• Sherly Bouche
• Christya Boucher, M.S.ED
• Diana Boucher, LMSW
• Lena Bouchkanets, O.T.
• Marley Boucicaut Boucicaut
• Lilia Boudnik, CD
• Leon Dimitrios Boudourakis, MD, MHS
• Gabrielle Boudreau, MSN, WHNP

• Physician Assistant in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Physician Assistant in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2024; 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.