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

Michael D Boucher, PA

Individual provider Physician Assistant · NPI 1386068310

Michael D Boucher, PA is a Physician Assistant in Brooklyn, New York. Qualified in 2014, 12 years ago. Practices with Maimonides Faculty Practice Plan, a 246-clinician group and accepts Medicare assignment. Licensed in New York.

Years since qualifying
12
Licensed in
NY
In the registry since
2014
What do these letters mean?
PA — Physician Assistant
A licensed clinician who examines, diagnoses and treats under a physician's supervision.

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Practice location Address checks out

3808 14th Ave
Brooklyn, NY 11218-3610
Phone: (718) 972-2424
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 026903 (NY)

Record details

NPI number1386068310
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedFebruary 11, 2014
Last updated in NPPESAugust 21, 2024
Certification dateAugust 21, 2024
Mailing address141 Franklin Ave, Brooklyn, NY 11205-2728

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Maimonides Faculty Practice Plan — 246 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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