Axel Bouchard, PHD

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY10473 Issued in FL

Practice address

13099 S Cleveland Ave Ste 300
Fort Myers, FL 33907-3835

Phone

(239) 936-1336

NPI assigned

Apr 27, 2015

Last updated

Aug 20, 2019By 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 2

Addresses

Medicare fee-for-service enrollment

Enrolled in IA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

67.97 of 100Reported as apm

Quality

34.29

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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.

• Clarinda Regional Health Center

  • Critical Access Hospital
  • Clarinda, IA
  • NPI 1366486946
  Medicare reassignment NPD
• Clarinda Regional Health Center

  dba Clarinda Medical Associates

  • Family Medicine Physician
  • Clarinda, IA
  • NPI 1629196241
  Medicare reassignment NPD

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

{
    "created_epoch": "1430092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566259200000",
    "number": "1962889139",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13099 S CLEVELAND AVE STE 300",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073835"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13099 S CLEVELAND AVE STE 300",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339073835",
            "telephone_number": "239-936-1336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHARD",
        "first_name": "AXEL",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-27",
        "last_updated": "2019-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY10473",
            "primary": false
        },
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY10473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Margaret Theresa Boswell, PA
• Diozzel Botelho
• Nestor Botta Gonzalez
• Bottoms Up Medical Systems Inc.
• James Bottoms, PHARMACIST
• Nancy Ellen Bouchard, DDS
• Michelle M. Boudreau, D.O.
• Ann Boudreaux, M.D.
• Denise April Bounds, RPAC
• Donald Bounds, PA

• Clinical Neuropsychologist in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinical Neuropsychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2019; 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.