Yasir Hamzeh Bouchi, MD

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

11975 Issued in GA

Practice address

1120 15TH St
Augusta, GA 30912-5052

Phone

(706) 721-2503

NPI assigned

Jun 12, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: ybouchi21880@tallahasseememorial.direct-ci.com

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

{
    "created_epoch": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591920000000",
    "number": "1962027227",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2073 SUGARSTONE DR",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300435052",
            "telephone_number": "404-917-5650"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1120 15TH ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309125052",
            "telephone_number": "706-721-2503"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2073 Sugarstone Dr",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300435052",
            "country_code": "US",
            "telephone_number": "404-917-5650",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUCHI",
        "first_name": "YASIR",
        "middle_name": "HAMZEH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-06-12",
        "last_updated": "2020-06-12",
        "certification_date": "2020-06-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "11975",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marilyn Sandra Botta, MARILYN BOTTA
• Alissa Dean Bottoms
• Melissa Bou Jaoude, MD
• Michele Dupuis Bouchard, LPC
• Cheryl Joyce Boucher, LPC
• Patrick A. Boudewyns, PHD
• Jacob Boudreaux, MD
• Jessica Boudreaux, RN
• Alphee J. T. Bouffard, DDS
• Andrew Bouffler, MD

• Surgery Physician in Augusta, GA
• Providers in Augusta, GA by specialty
• Surgery Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 12, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.