Ian Anthony Boucher, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA58296 Issued in CA

Practice address

300 Pasteur Dr
Palo Alto, CA 94305-2200

Phone

(650) 724-7500

NPI assigned

Aug 23, 2019

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

Medicare fee-for-service enrollment

Enrolled in CA

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, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Stanford Health CareGroup PAC ID 6709797491, 3,152 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Stanford Health Care Hospital, Stanford, CA, CCN 050441

Merit-based Incentive Payment System (MIPS)

Final score

88.53 of 100Reported as group

Quality

87.08

Promoting interoperability

100

Improvement activities

40

Cost

69.51

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: iboucher278555@direct.stanfordhealthcare.org

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.

• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  Medicare reassignment Care Compare group NPD (past)
• LPCH Medical Group Div of Lucile

  • Children's Hospital
  • Palo Alto, CA
  • NPI 1417907940
  Medicare reassignment
• Stanford Health Care

  • Radiation Oncology Physician
  • Pleasanton, CA
  • NPI 1124561758
  NPD
• Stanford Health Care

  • Specialty Pharmacy
  • Mountain View, CA
  • NPI 1760366132
  NPD

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

• Stanford Health Care

  • Radiation Oncology Physician
  • Pleasanton, CA
  • NPI 1124561758

  Hospital

  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Emeryville, CA
  • NPI 1275076325
  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Emeryville, CA
  • NPI 1285177337
  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1437292927
  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Pleasanton, CA
  • NPI 1467990465
  Care Compare affiliation
• Stanford Health Care

  • General Acute Care Hospital
  • Stanford, CA
  • NPI 1871543215
  Care Compare affiliation
• Stanford Life Flight

  • Air Ambulance
  • Stanford, CA
  • NPI 1114063203

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1566518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600992000000",
    "number": "1730736752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943052200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 PASTEUR DR",
            "city": "PALO ALTO",
            "state": "CA",
            "postal_code": "943052200",
            "telephone_number": "650-724-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "IAN",
        "middle_name": "ANTHONY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-23",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "PA58296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Bosh
• Rosemary Botch
• Shilpa Reddy Botla
• Thomas Bottyan
• Charbel Bou Khalil
• David Jean-Guy Boudreault, M.D.
• Jennifer Boule, MD
• Heidi M Boules, MD
• Heather Bernice Boulting, ACNPC-AG
• Matthew Richard Bourne

• Physician Assistant in Palo Alto, CA
• Providers in Palo Alto, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.