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

Orland Kenton Boucher, PA

Individual provider Surgical Physician Assistant · NPI 1013037357

Orland Kenton Boucher, PA is a Physician Assistant in Scottsdale, Arizona. Qualified in 2004, 22 years ago. Practices with Mayo Clinic Arizona, a 1,616-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Arizona and New York.

Years since qualifying
22
Licensed in
AZ, NY
In the registry since
2007
Specialties on file
2
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

13400 E Shea Blvd
Scottsdale, AZ 85259-5404
Phone: (480) 301-8000
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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 3830 (AZ)
Surgical Physician Assistant Taxonomy 363AS0400X · Licence 010398 (NY)

Record details

NPI number1013037357
Entity typeIndividual (Type 1)
GenderMale
Credentials PA
Sole proprietorNo
NPI enumeratedMarch 30, 2007
Last updated in NPPESSeptember 10, 2020
Certification dateSeptember 10, 2020

Medicare enrollment

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

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Mayo Clinic Arizona — 1616 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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