Organization Active NPI

Premier Rheumatology, PLLC

  • Rheumatology Physician
  • Coconut Creek, FL
National Provider Identifier
1770443871
Registry record updated Feb 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
Legal business name
PREMIER RHEUMATOLOGY, PLLC
Practice address
4400 W Sample Rd Ste 236
Coconut Creek, FL 33073-3473
Phone
(954) 507-6634
NPI assigned
Nov 12, 2025
Last updated
Feb 22, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2026

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

Authorized official

Name
Mouriel Deyanira Boucher, DONPI 1972009868
Title
Rheumatologist
Phone
(561) 421-4500

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X Primary

Addresses

Primary practice location

4400 W Sample Rd Ste 236
Coconut Creek, FL 33073-3473

Mailing address

4400 W Sample Rd Ste 236
Coconut Creek, FL 33073-3473
Phone (954) 507-6634

Other practice location 1

2900 N Military Trl Ste 230
Boca Raton, FL 33431-6347
Phone (561) 421-4500

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260210000218 FL Part B Supplier - Clinic/Group Practice 7214416320 Receives reassigned benefits from 2 practitioners
Practice locations: Boca Raton, FL; Coconut Creek, FL

National Provider Directory

National Provider Directory

Locations

4400 W Sample Rd
Ste 236
Coconut Creek, FL 33073
Phone (561) 421-4500

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1762905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771718400000",
    "number": "1770443871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W SAMPLE RD STE 236",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733473",
            "telephone_number": "954-507-6634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W SAMPLE RD STE 236",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733473",
            "telephone_number": "954-507-6634"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2900 N Military Trl Ste 230",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334316347",
            "country_code": "US",
            "telephone_number": "561-421-4500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PREMIER RHEUMATOLOGY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-11-12",
        "last_updated": "2026-02-22",
        "certification_date": "2026-02-22",
        "status": "A",
        "authorized_official_last_name": "BOUCHER",
        "authorized_official_first_name": "MOURIEL",
        "authorized_official_middle_name": "DEYANIRA",
        "authorized_official_title_or_position": "RHEUMATOLOGIST",
        "authorized_official_telephone_number": "561-421-4500",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.