Individual provider Active NPI

Joseph L Bouchard, M.D.

  • Cardiovascular Disease Physician
  • Marlborough, MA
National Provider Identifier
1609892199
Registry record updated Oct 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Cardiovascular Disease PhysicianTaxonomy code 207RC0000X
License
226130 Issued in MA
Practice address
159 Union St
Marlborough, MA 01752-1274
Phone
(508) 624-9687
Fax
(508) 624-9689
NPI assigned
Jul 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Cardiovascular Disease Physician 207RC0000X 226130 MA Primary

Addresses

Primary practice location

159 Union St
Marlborough, MA 01752-1274

Mailing address

PO Box 415348
Boston, MA 02241-5348
Phone (800) 225-8885

Other practice location 1

333 SW Cutoff
Northborough, MA 01532-2130
Phone (774) 570-5000

Other identifiers 1

IdentifierTypeStateIssuer
110082093AMedicaidMA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address jbouchard11087@UmassMemorial.direct-ci.com
FHIR URL https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060313000165 MA Practitioner - Cardiovascular Disease (Cardiology) 8123035466 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Cardiovascular Disease (Cardiology)
Education
University of Massachusetts Medical School, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Umass Memorial Medical Group IncGroup PAC ID 4284539891, 2,494 clinicians

Practice addresses (Care Compare)

159 Union St
Suite 103
Marlborough, MA 01752-1274
Phone (508) 624-9687

Hospital & facility affiliations

  • Umass Memorial Medical Center/University Campus Hospital, Worcester, MA, CCN 220163
  • Marlborough Hospital Hospital, Marlborough, MA, CCN 220049
  • Umass Memorial Healthalliance Hospitals Hospital, Leominster, MA, CCN 220001
  • Umass Memorial Health - Harrington Hospital Hospital, Southbridge, MA, CCN 220019

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as apm
Quality
82.98
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
226130MAMDCardiovascular Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Umass Memorial Medical Group, Inc. CurrentSince Jul 1, 2009 Accepting new patients
Umass Memorial Medical Group Inc CurrentSince Jul 1, 2009 Accepting new patients

Locations

159 Union St
Ste 103
Marlborough, MA 01752
Phone (508) 485-0801

159 Union St
Marlborough, MA 01752
Phone (508) 481-0246

333 SW Cutoff
Northborough, MA 01532
Phone (774) 570-5000

340 Thompson Rd
Webster, MA 01570
Phone (508) 943-2600

55 Lake Ave N
Worcester, MA 01655
Phone 508334100048862

Interoperability endpoints

  • Direct secure messaging: jbouchard11087@umassmemorial.direct-ci.com

Organizations & group practices 2

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1152921600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603584000000",
    "number": "1609892199",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 415348",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022415348",
            "telephone_number": "800-225-8885",
            "fax_number": "508-334-1977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "159 UNION ST",
            "city": "MARLBOROUGH",
            "state": "MA",
            "postal_code": "017521274",
            "telephone_number": "508-624-9687",
            "fax_number": "508-624-9689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "333 SW Cutoff",
            "address_purpose": "LOCATION",
            "city": "Northborough",
            "state": "MA",
            "postal_code": "015322130",
            "country_code": "US",
            "telephone_number": "774-570-5000",
            "fax_number": "774-570-5050",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "JOSEPH",
        "middle_name": "L",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-15",
        "last_updated": "2020-10-25",
        "certification_date": "2020-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RC0000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "MA",
            "license": "226130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110082093A",
            "state": "MA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "jbouchard11087@UmassMemorial.direct-ci.com",
            "affiliation": "N",
            "address_1": "159 Union St",
            "city": "Marlborough",
            "state": "MA",
            "country_code": "US",
            "postal_code": "017521274",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0978.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "159 Union St",
            "city": "Marlborough",
            "state": "MA",
            "country_code": "US",
            "postal_code": "017521274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Marlborough, MA

Sources for this page

Verify at the official NPI Registry.