Individual provider Active NPI

Mouriel Deyanira Boucher, DO

  • Rheumatology Physician
  • Coconut Creek, FL
National Provider Identifier
1972009868
Registry record updated Sep 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
OS20011 Issued in FL
Practice address
4400 W Sample Rd Ste 236
Coconut Creek, FL 33073-3473
Phone
(561) 421-4500
Fax
(561) 440-3280
NPI assigned
Apr 1, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rheumatology Physician 207RR0500X OS20011 FL Primary

Addresses

Primary practice location

4400 W Sample Rd Ste 236
Coconut Creek, FL 33073-3473

Mailing address

4400 W Sample Rd Ste 236
Coconut Creek, FL 33073-3473
Phone (561) 421-4500

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20230602002739 FL Practitioner - Rheumatology 3072916048 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Lake Erie College of Osteopathic Medicine, Erie, 2018
Medicare assignment
May accept Medicare assignment
Group practices
Premier Rheumatology, PLLCGroup PAC ID 7214416320, 2 clinicians
Rheumatic Wellness InstituteGroup PAC ID 9638440290, 6 clinicians

Practice addresses (Care Compare)

4400 W Sample Rd
Suite 236
Coconut Creek, FL 33073-3473
Phone (954) 507-6634

6280 Sunset Dr
Suite 501
South Miami, FL 33143-4870
Phone (305) 671-3447

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OS20011FLMDRheumatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rheumatic Wellness Institute Rheumatology CurrentSince Dec 1, 2024 Accepting new patients
Premier Rheumatology, PLLC Rheumatology CurrentSince Nov 10, 2025 Accepting new patients
American Arthritis & Rheumatology Associates LLC Rheumatology CurrentSince Jun 1, 2023 Accepting new patients

Locations

2255 Glades Rd
Ste 228W
Boca Raton, FL 33431
Phone (561) 699-7101

2900 N Military Trl
Ste 230
Boca Raton, FL 33431
Phone (561) 859-3109

1831 N Belcher Rd
Ste D2
Clearwater, FL 33765
Phone (727) 734-6631

4400 W Sample Rd
Ste 236
Coconut Creek, FL 33073
Phone (954) 507-6634

20880 W Dixie Hwy
Ste 101
Miami, FL 33180
Phone (305) 682-1441

6280 Sunset Dr
Ste 501
South Miami, FL 33143
Phone (305) 666-1352

Interoperability endpoints

  • Direct secure messaging: mouriel.boucher.p31@direct.aara1.nextgenshare.com
  • Direct secure messaging: mboucher1034347@direct.hopkinsmedicine.org
  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Organizations & group practices 3

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1522540800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789689600000",
    "number": "1972009868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4400 W SAMPLE RD STE 236",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733473",
            "telephone_number": "561-421-4500",
            "fax_number": "561-440-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4400 W SAMPLE RD STE 236",
            "city": "COCONUT CREEK",
            "state": "FL",
            "postal_code": "330733473",
            "telephone_number": "561-421-4500",
            "fax_number": "561-440-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUCHER",
        "first_name": "MOURIEL",
        "middle_name": "DEYANIRA",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-01",
        "last_updated": "2026-09-18",
        "certification_date": "2026-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "FL",
            "license": "OS20011",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coconut Creek, FL

Sources for this page

Verify at the official NPI Registry.