Individual provider Active NPI

Caroline Boucher

  • Family Nurse Practitioner
  • Garden City, NY
National Provider Identifier
1871033571
Registry record updated Feb 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
F353842-01 Issued in NY
Practice address
200 Garden City PLZ Ste 100
Garden City, NY 11530-3337
Phone
(407) 757-5505
NPI assigned
Feb 28, 2017
Last updated
Feb 22, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X F353842-01 NY Primary
Registered Nurse 163W00000X 714565 NY
Registered Nurse 163W00000X 9427482 FL

Addresses

Primary practice location

200 Garden City PLZ Ste 100
Garden City, NY 11530-3337

Mailing address

200 Garden City PLZ Ste 100
Garden City, NY 11530-3337
Phone (407) 757-5505

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20260306003002 NY Practitioner - Nurse Practitioner 2668954660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1111 Marcus Ave
New Hyde Park, NY 11042-1034

2 Brighton Rd
Suite 300
Clifton, NJ 07012-1645

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9427482FLMDRegistered Nurse
714565NYMDRegistered Nurse
F353842-01NYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Nsuh Plainview Physicians Ufp Corporation CurrentSince Jan 27, 2026 Accepting new patients

Locations

1575 E 19th St
Brooklyn, NY 11230
Phone (718) 339-3777

11241 Queens Blvd
Forest Hills, NY 11375
Phone (347) 321-7911

200 Garden City Plz
Ste 100
Garden City, NY 11530
Phone (516) 390-2415

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1488240000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771718400000",
    "number": "1871033571",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 GARDEN CITY PLZ STE 100",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303337",
            "telephone_number": "407-757-5505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GARDEN CITY PLZ STE 100",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "115303337",
            "telephone_number": "407-757-5505"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "CAROLINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-02-28",
        "last_updated": "2026-02-22",
        "certification_date": "2026-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "NY",
            "license": "F353842-01",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "714565",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9427482",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Garden City, NY

Sources for this page

Verify at the official NPI Registry.