Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dominica Boucher

Individual provider Acute Care Nurse Practitioner · NPI 1104615087

Dominica Boucher is a Nurse Practitioner in Worcester, Massachusetts. Qualified in 2024, 2 years ago. Practices with Umass Memorial Medical Group Inc, a 2,467-clinician group and accepts Medicare assignment. Licensed in Massachusetts.

Years since qualifying
2
Licensed in
MA
In the registry since
2025
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

55 Lake Ave N
Worcester, MA 01655-0002
Phone: (508) 334-6691
Fax: (774) 441-7727
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence RN2371640 (MA)
Acute Care Nurse Practitioner Taxonomy 363LA2100X · Licence RN2371640 (MA)

Record details

NPI number1104615087
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedMay 6, 2025
Last updated in NPPESJune 5, 2025
Certification dateJune 5, 2025
Mailing addressPo Box 415348, Boston, MA 02241-5348

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Umass Memorial Medical Group Inc — 2467 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Worcester