Maya Grace Bouchard

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

795 Middle St
Fall River, MA 02721-1733

Phone

(508) 674-5600

NPI assigned

Nov 25, 2014

Last updated

Dec 3, 2019By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MA

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, 2014

Medicare assignment

May accept Medicare assignment

Group practices

Lifespan Physician Group of Massachusetts IncGroup PAC ID 3870020399, 458 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Saint Anne's Hospital Hospital, Fall River, MA, CCN 220020

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: mkaram41741@direct.southcoast.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.

• Lifespan Physician Group of Massachusetts Inc

  dba Brown Health Medical Group

  • Family Medicine Physician
  • Taunton, MA
  • NPI 1235957713

  Emergency Medicine

  Medicare reassignment Care Compare group NPD
• First Physicians Corporation

  • Emergency Medicine Physician
  • Fall River, MA
  • NPI 1255493474
  Medicare reassignment
• Steward Emergency Physicians, Inc

  • Emergency Medicine Physician
  • Ayer, MA
  • NPI 1780971275
  Medicare reassignment
• Lifespan of Massachusetts - Fall River Inc

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1972330165

  Emergency Medicine

  NPD (past)

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

• Lifespan of Massachusetts - Fall River Inc

  • General Acute Care Hospital
  • Fall River, MA
  • NPI 1972330165
  Care Compare affiliation

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

{
    "created_epoch": "1416873600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1575331200000",
    "number": "1487051025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "28 VILLAGE ST",
            "city": "SOUTH EASTON",
            "state": "MA",
            "postal_code": "023751755",
            "telephone_number": "774-644-7972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "795 MIDDLE ST",
            "city": "FALL RIVER",
            "state": "MA",
            "postal_code": "027211733",
            "telephone_number": "508-674-5600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "MAYA",
        "middle_name": "GRACE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-11-25",
        "last_updated": "2019-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MA",
            "license": "PA5347",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Wendy Marie Botelho, MA
• George Botros, M.D.
• George S Botros, MD
• Chelsea M Bouchard, OTR/L
• Danielle Lee Bouchard, NP
• Melaine Bouchard, LMHC
• Ronald P Bouchard Jr., RPH
• Geoffrey Paul Boucher-Flood
• Patricia A Boucher-Fortin, LPN
• Elizabeth Rodman Boucher, LICSW

• Physician Assistant in Fall River, MA
• Providers in Fall River, MA by specialty
• Physician Assistant in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2019; 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.