Thaddeus Stanice Boucree, M.D., DDS

Primary specialty

Plastic Surgery PhysicianTaxonomy code 208200000X

License

25MA10083000 Issued in NJ

Practice address

535 Sycamore Ave
Shrewsbury, NJ 07702

Phone

(732) 741-0970

Fax

(732) 747-2606

NPI assigned

Jul 15, 2008

Last updated

Sep 15, 2025By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NJ, NY2 enrollments

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 2

Specialty

General Surgery

Education

Meharry Medical College School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vohra Wound Physicians of Ny PLLCGroup PAC ID 0446410435, 35 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Vohra Wound Physicians of Ny, PLLC

  • Family Medicine Physician
  • New York, NY
  • NPI 1447527320
  Medicare reassignment Care Compare group NPD
• Vohra Post Acute Care Physicians of the East, PA

  • Family Medicine Physician
  • Miramar, FL
  • NPI 1063848968

  NJ, Plastic Surgery

  Medicare reassignment NPD
• Sheila a Bond MD, PC

  • Plastic Surgery Physician
  • Montclair, NJ
  • NPI 1205066974
  NPD (past)

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

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757894400000",
    "number": "1942464417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 SYCAMORE AVE",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "077024224",
            "telephone_number": "732-741-0970",
            "fax_number": "732-747-2606"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 SYCAMORE AVE",
            "city": "SHREWSBURY",
            "state": "NJ",
            "postal_code": "07702",
            "telephone_number": "732-741-0970",
            "fax_number": "732-747-2606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCREE",
        "first_name": "THADDEUS",
        "middle_name": "STANICE",
        "credential": "M.D., DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2025-09-15",
        "certification_date": "2025-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "NJ",
            "license": "25MA10083000",
            "primary": false
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NJ",
            "license": "25MA10083000",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "",
            "desc": "Plastic Surgery",
            "state": "NY",
            "license": "301972",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://172.254.9.13:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.1",
            "affiliationName": "Bluemark",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "40 Sunset Ridge Rd Ste 120",
            "city": "New Paltz",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125611039",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Jessica Cherie Blick, FNP
• Block Master Productions, LLC (BMP Post-Op Pain Management Assoc)
• Lauren Boccardo, OTR/L
• Jaimee Bogdon, MSN, FNP-C
• Robert Paul Bonitz Jr.
• Krystal Bowers, PT, DPT
• Danit Vera Brahver, M.D.
• Brandywine Assisted Living @ Sycamore, LLC
• Robin Hope Braverman, LCSW
• Courtney Brennan, NP

• Plastic Surgery Physician in Shrewsbury, NJ
• Providers in Shrewsbury, NJ by specialty
• Plastic Surgery Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2025; 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.