Nicole Christine Boucuvalas, CNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

APRN.CNP.020071 Issued in OH

Practice address

825 N Main St Ste 130
Springboro, OH 45066-2100

Phone

(937) 433-5309

Fax

(937) 424-3650

NPI assigned

Oct 27, 2016

Last updated

Sep 29, 2026By the provider in NPPES

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

Other identifiers 2

Electronic endpoints 2

Medicare fee-for-service enrollment

Enrolled in OH

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

Nurse Practitioner

Education

Other, 2016

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Kettering Independent Medical Group IncGroup PAC ID 3173710936, 699 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Kettering Health Dayton Hospital, Dayton, OH, CCN 360133
• Soin Medical Center Hospital, Beaver Creek, OH, CCN 360360
• Kettering Health Main Campus Hospital, Kettering, OH, CCN 360079
• Kettering Health Greene Memorial Hospital, Xenia, OH, CCN 360026

Merit-based Incentive Payment System (MIPS)

Final score

81.34 of 100Reported as group

Quality

63.67

Promoting interoperability

100

Improvement activities

40

Cost

74.14

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: nboucuvalas565490@direct.ketteringhealth.org

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Kettering Independent Medical Group Inc

  • Orthopaedic Surgery Physician
  • Miamisburg, OH
  • NPI 1629387865
  Medicare reassignment Care Compare group NPD
• Dayton Osteopathic Hospital

  dba Kettering Health Dayton - Cassano

  • Multi-Specialty Clinic/Center
  • Dayton, OH
  • NPI 1588630347
  Medicare reassignment NPD
• Dayton Osteopathic Hospital

  dba Kettering Health Washington Township Womens Care

  • Obstetrics & Gynecology Physician
  • Dayton, OH
  • NPI 1053386102
  NPD
• Dayton Osteopathic Hospital

  dba Kettering Health Specialty Pharmacy

  • Specialty Pharmacy
  • Kettering, OH
  • NPI 1629511688
  NPD

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

• Beavercreek Medical Center

  dba Soin Medical Center

  • General Acute Care Hospital
  • Beavercreek, OH
  • NPI 1760764849
  Care Compare affiliation
• Dayton Osteopathic Hospital

  dba Kettering Health Dayton

  • General Acute Care Hospital
  • Dayton, OH
  • NPI 1053339507
  Care Compare affiliation
• Greene Memorial Hospital Inc

  dba Kettering Health Greene Memorial

  • General Acute Care Hospital
  • Xenia, OH
  • NPI 1255317848
  Care Compare affiliation
• Kettering Medical Center

  dba Kettering Health Main Campus

  • General Acute Care Hospital
  • Kettering, OH
  • NPI 1043233984
  Care Compare affiliation

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1851843668",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "825 N MAIN ST STE 130",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450662100",
            "telephone_number": "937-433-5309",
            "fax_number": "937-247-5154"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "825 N MAIN ST STE 130",
            "city": "SPRINGBORO",
            "state": "OH",
            "postal_code": "450662100",
            "telephone_number": "937-433-5309",
            "fax_number": "937-424-3650"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "165 Edwin C. moses Blvd",
            "address_purpose": "LOCATION",
            "city": "DAYTON",
            "state": "OH",
            "postal_code": "454028472",
            "country_code": "US",
            "telephone_number": "937-558-0200",
            "fax_number": "937-558-0201",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1989 Miamisburg Centerville Rd Ste 304",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454593823",
            "country_code": "US",
            "telephone_number": "937-558-0200",
            "fax_number": "937-558-0195",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "450B Washington Jackson Rd Ste 111",
            "address_purpose": "LOCATION",
            "city": "Eaton",
            "state": "OH",
            "postal_code": "453207601",
            "country_code": "US",
            "telephone_number": "937-558-0200",
            "fax_number": "937-558-0195",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1250 W National Rd Ste 100A",
            "address_purpose": "LOCATION",
            "city": "Englewood",
            "state": "OH",
            "postal_code": "453159505",
            "country_code": "US",
            "telephone_number": "937-558-0200",
            "fax_number": "937-558-0195",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8701 Old Troy Pike Ste 40A",
            "address_purpose": "LOCATION",
            "city": "Huber Heights",
            "state": "OH",
            "postal_code": "454241066",
            "country_code": "US",
            "telephone_number": "937-558-0200",
            "fax_number": "937-558-0195",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUCUVALAS",
        "first_name": "NICOLE",
        "middle_name": "CHRISTINE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-10-27",
        "last_updated": "2026-09-29",
        "certification_date": "2020-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OH",
            "license": "APRN.CNP.020071",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0190775",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE",
            "identifier": "H522020",
            "state": "OH"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nboucuvalas565490@direct.ketteringhealth.org",
            "affiliation": "N",
            "address_1": "825 N Main St Ste 130",
            "city": "Springboro",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450662100",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://khnarr.ketthealth.com/FHIR-PROD/api/FHIR/DSTU2/",
            "affiliation": "N",
            "address_1": "825 N Main St Ste 130",
            "city": "Springboro",
            "state": "OH",
            "country_code": "US",
            "postal_code": "450662100",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kevin Brett Biltz
• Maegan Birk
• F Ward Blair, MD
• Karen Blake, OTR
• Kassandra Danielle Bond, D.O.
• William Ralph Box, M.DIV, M.S., LPCC
• Heather Nicole Brahm, CNP
• Theresa Braun, PHARMD
• Brickner Chiropractic Health Center, Inc.
• Dennis Scott Brickner, CHIROPRACTOR

• Family Nurse Practitioner in Springboro, OH
• Providers in Springboro, OH by specialty
• Family Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.