Correne L Boucher, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

037979 Issued in CT

Practice address

400 Saybrook Rd
Suite 206
Middletown, CT 06457-4773

Phone

(860) 344-0333

Fax

(860) 344-9703

NPI assigned

Aug 11, 2006

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

Enrolled in CT

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: correne.boucher.npi1659382000.phpct@direct.optumcare.masshiway.net

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.

• Prohealth Physicians PC

  • Family Medicine Physician
  • Farmington, CT
  • NPI 1720194053

  CT, Pediatrics

  Medicare reassignment NPD

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

{
    "created_epoch": "1155254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1659382000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4 FARM SPRINGS RD",
            "address_2": "PROHEALTH PHYSICIANS",
            "city": "FARMINGTON",
            "state": "CT",
            "postal_code": "060322573",
            "telephone_number": "860-284-5200",
            "fax_number": "860-284-5333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 SAYBROOK RD",
            "address_2": "SUITE 206",
            "city": "MIDDLETOWN",
            "state": "CT",
            "postal_code": "064574773",
            "telephone_number": "860-344-0333",
            "fax_number": "860-344-9703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "CORRENE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "CT",
            "license": "037979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caitlin Boots
• Jamie Bordner, PHARMD
• John J Borkowski, M.D.
• Susan Boronese, PHARM.D.
• Yevgeniya Borovinskaya, DO
• Colleen Bouffard, RDH
• Alisha Bourassa
• Ryan Boutin, DO
• Jane Bouvier, LCSW
• Stephanie Jeanne P I I Lani Boyce

• All providers in Middletown, CT
• Pediatrics Physician in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.