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MATTHEW CHARLES BOUCHE PT, CSCS
NPI 1033785027
Physical Therapist - Sports in St. Paul, MN

Active since June 01, 2021Accepts Medicare Assignment
81.72/100
CMS Quality Rating
2155 FORD PARKWAY, ST. PAUL, MN 55116(651) 696-5010 Get Directions Write a Review

NPPES record last updated: June 1, 2021. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Matthew Charles Bouche Pt, Cscs NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MATTHEW CHARLES BOUCHE PT, CSCS (NPI 1033785027) is an individual sports provider in St. Paul, Minnesota, licensed in Minnesota (11806) and active in the NPI registry since June 2021. He is a graduate of Other (2020).

NPPES Registry Identity

NPI1033785027
Entity TypeIndividualMale
Primary Taxonomy2251S0007X
Provider Legal NameMATTHEW CHARLES BOUCHECredential: PT, CSCS
Location Address2155 FORD PARKWAYSt. Paul, MN 55116-1862
Mailing Address3519 Sawgrass Trl EEagan, MN 55123-1367 · (920) 621-7074
Phone(651) 696-5010
Sole ProprietorNo
Medical School CMSOtherGraduated 2020
Enumeration DateJune 1, 2021
NPPES CertifiedMay 27, 2021
✔ NPI 1033785027 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyPhysical Therapist · SportsRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Taxonomy Code2251S0007X
License✔ Licensed in MN · 11806
Definition
A licensed physical therapist, including but not limited to an individual who is a Board Certified Specialist in Sports Physical Therapy, who has demonstrated specialized knowledge and skill in human anatomy and physiology, movement science, pathology and pathophysiology, medical and surgical intervention, and health and wellness, as well as rehabilitation/return to sports, management of acute injury/illness, medical and surgical consideration, injury prevention, and sports performance enhancement.
Also ListedPhysical Therapist · OrthopedicTaxonomy 2251X0800X · License 11806 (MN)
2155 FORD PARKWAY, St. Paul, MN 55116
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Matthew Charles Bouche Pt, Cscs is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7214337476
PECOS Enrollment IDI20210610001063

Medicare Billing Reassignments

2

Medicare enrollment records show Matthew Bouche reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Fairview Express Care
2.6 mi
General Practice
1700 UNIVERSITY AVE W
Saint Paul, MN 55104
  • Reassigned Medicare billing, Minnesota enrollment
  • 3,633 clinicians in this Medicare group
NPI 1346722675 (612) 672-6740
Tria Orthopaedic Center LLC
7.9 mi
Orthopaedic Surgery
8100 NORTHLAND DR
Bloomington, MN 55431
  • Reassigned Medicare billing, Minnesota enrollment
  • 693 clinicians in this Medicare group
NPI 1346624384 (952) 831-8742

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes 97110
This therapy involves exercises to boost strength, endurance, flexibility, and range of motion. Each session lasts 15 minutes. The goal is to improve physical function and overall health. It's a safe, beneficial method for enhancing well-being and fitness.
57 services13 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

81.72/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality69.86
Promoting Interoperability100
Improvement Activities40
Cost59.73

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Matthew Bouche's NPI number?

The NPI number for Matthew Bouche is 1033785027. It was assigned to this individual provider in the NPPES registry on June 1, 2021.

Where is Matthew Bouche located?

Matthew Bouche practices at 2155 Ford Parkway, St. Paul, MN 55116. The listed phone number is (651) 696-5010.

What is Matthew Bouche's specialty?

The primary specialty registered for this NPI is Physical Therapist, specializing in Sports, with taxonomy code 2251S0007X.

Is Matthew Bouche enrolled in Medicare?

Yes. Matthew Bouche is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Matthew Bouche's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Matthew Bouche reassigns Medicare benefits to 2 organizations: Fairview Express Care (Saint Paul, MN) and Tria Orthopaedic Center LLC (Bloomington, MN). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Matthew Bouche's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Matthew Bouche was last updated on June 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.