Emma Rose Boutorwick, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

5601014316 Issued in MI

Practice address

4 Columbus Ave Ste 160
Bay City, MI 48708-6478

Phone

(989) 393-2777

NPI assigned

Sep 9, 2025

Last updated

Sep 14, 2026By 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 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1757376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789344000000",
    "number": "1538040266",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 COLUMBUS AVE STE 160",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086478",
            "telephone_number": "989-393-2777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4 COLUMBUS AVE STE 160",
            "city": "BAY CITY",
            "state": "MI",
            "postal_code": "487086478",
            "telephone_number": "989-393-2777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTORWICK",
        "first_name": "EMMA",
        "middle_name": "ROSE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-09",
        "last_updated": "2026-09-14",
        "certification_date": "2026-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "MI",
            "license": "5601014316",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katelyn Nicole Bouckaert, LLMSW
• Michael Donald Bouckaert, RPH.
• Ashley Christine Boudreau, REGISTERED NURSE
• Jill Bourcier-Schultz
• Angela Marti Bourdlaies
• Christine Boven
• Leslie Bovia
• Samara Rose Bowman
• Erin Bowns
• Chelsea Glenn Boyd

• Surgical Physician Assistant in Bay City, MI
• Providers in Bay City, MI by specialty
• Surgical Physician Assistant in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.