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JEFFREY LOBERIANO BOUCHER PMHNP
NPI 1124973938
Nurse Practitioner - Psychiatric/Mental Health in Old Town, ME

Active since February 27, 2026PECOS Enrolled
59 DAVIS ST, OLD TOWN, ME 04468(323) 898-9622 Get Directions Write a Review

NPPES record last updated: February 27, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Jeffrey Loberiano Boucher Pmhnp NPPES

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

JEFFREY LOBERIANO BOUCHER PMHNP (NPI 1124973938) is an individual psychiatric/mental health provider in Old Town, Maine, licensed in California (95038702) and active in the NPI registry since February 2026. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1124973938
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameJEFFREY LOBERIANO BOUCHERCredential: PMHNP
Location Address59 DAVIS STOld Town, ME 04468-1337
Mailing Address59 Davis StOld Town, ME 04468-1337 · (323) 898-9622
Phone(323) 898-9622
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateFebruary 27, 2026
NPPES CertifiedFebruary 27, 2026
✔ NPI 1124973938 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95038702
59 DAVIS ST, Old Town, ME 04468
Open in Google Maps ↗

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Harvard Pilgrim Health Care.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jeffrey Loberiano Boucher Pmhnp is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

PECOS PAC ID3072072370
PECOS Enrollment IDI20260827000572
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Jeffrey Boucher reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Acadia Hospital Corp
9.8 mi
Psychiatric Hospital
268 STILLWATER AVENUE
Bangor, ME 04401
  • Reassigned Medicare billing, Maine enrollment
  • 348 clinicians in this Medicare group
NPI 1215940523 (207) 973-6470

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 04468 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$82.58 typical visit price
range $53.26 – $162.77
Typical copayment $20.64 (range $13.31 – $40.69)
Most-billed visit code 99203
Established Patient
$94.60 typical visit price
range $16.90 – $132.79
Typical copayment $23.65 (range $4.22 – $33.19)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Jeffrey Boucher's NPI number?

The NPI number for Jeffrey Boucher is 1124973938. It was assigned to this individual provider in the NPPES registry on February 27, 2026.

Where is Jeffrey Boucher located?

Jeffrey Boucher practices at 59 Davis St, Old Town, ME 04468. The listed phone number is (323) 898-9622.

What is Jeffrey Boucher's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jeffrey Boucher enrolled in Medicare?

Yes. Jeffrey Boucher is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Jeffrey Boucher's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jeffrey Boucher reassigns Medicare benefits to Acadia Hospital Corp (Bangor, ME). The 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 Jeffrey Boucher's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Jeffrey Boucher accept?

Health plans from Anthem Blue Cross and Blue Shield and Harvard Pilgrim Health Care list Jeffrey Boucher as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Jeffrey Boucher was last updated on February 27, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months 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.