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

Mr. Scott Emmanuel Boucan

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1508530429

Mr. Scott Emmanuel Boucan is an Anesthesiology Assistant in Marietta, Georgia. Qualified in 2022, 4 years ago. Practices with Piedmont Anesthesia LLC, a 554-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
4
Licensed in
GA
In the registry since
2021
Specialties on file
2
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Practice location Address checks out

2540 Windy Hill Rd SE
Marietta, GA 30067-8605
Phone: (470) 644-1274
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 988 Oriole Way Sw, Mableton, GA 30126-4136 — (404) 697-9142

Specialties & licences

Anesthesiologist Assistant (primary) Taxonomy 367H00000X (GA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1508530429
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedAugust 4, 2021
Last updated in NPPESMarch 21, 2025
Certification dateMarch 21, 2025
Mailing address988 Oriole Way Sw, Mableton, GA 30126-4136

Medicare enrollment

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

Medicare specialtyANESTHESIOLOGY ASSISTANT
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Piedmont Anesthesia Llc — 554 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Marietta