Individual provider Active NPI

Tara C. Bouton, M.D.

  • Infectious Disease Physician
  • Boston, MA
National Provider Identifier
1760743686
Registry record updated Nov 26, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
LP03374 Issued in RI
Practice address
725 Albany St
Shapiro 9 B and C
Boston, MA 02118-3549
Phone
(617) 414-4290
NPI assigned
Jun 7, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X LP03374 RI Primary
Internal Medicine Physician 207R00000X 253126 MA

Addresses

Primary practice location

725 Albany St
Shapiro 9 B and C
Boston, MA 02118-3549

Mailing address

801 Albany St FL Ground
Boston, MA 02119-2560

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
I20181003002510 MA Practitioner - Infectious Disease 2961625363 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Tulane University School of Medicine, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Evans Medical Foundation IncGroup PAC ID 7416946546, 525 clinicians

Practice addresses (Care Compare)

1 Boston Medical Ctr PL
Boston, MA 02118-2908
Phone (617) 638-8000

72 E Newton St
CR Evans 124
Boston, MA 02118-2308
Phone (617) 638-7253

88 E Newton St
Boston, MA 02118-2308
Phone (617) 414-5405

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
253126MAMDInternal Medicine Physician
LP03374RIMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Boston Medical Center Corporation Current Accepting new patients
Evans Medical Foundation, Inc. Internal Medicine CurrentSince Jan 1, 2020 Accepting new patients

Locations

725 Albany St
#9B
Boston, MA 02118
Phone (617) 414-4290

88 Newton St
Boston, MA 02118
Phone (617) 638-7350

Interoperability endpoints

  • Direct secure messaging: tbouton120707@direct.bmc.masshiway.net

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 8

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": "1339027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574726400000",
    "number": "1760743686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ALBANY ST FL GROUND",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021192560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 ALBANY ST",
            "address_2": "SHAPIRO 9 B AND C",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021183549",
            "telephone_number": "617-414-4290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUTON",
        "first_name": "TARA",
        "middle_name": "C.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-07",
        "last_updated": "2019-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "RI",
            "license": "LP03374",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "MA",
            "license": "253126",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.