DANA BOUCEK
NPI 1154612117
Pediatrics - Pediatric Cardiology in Salt Lake City, UT

Active since April 26, 2011PECOS EnrolledAccepts Medicare Assignment
100 NORTH MARIO CAPECCHI DR., PRIMARY CHILDREN'S, SALT LAKE CITY, UT 84113(801) 662-5700 Get Directions Write a Review

NPPES record last updated: October 28, 2021. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Mar 17, 2018, Jun 15, 2017 (2 updates tracked since 2017).

About Dana Boucek NPPES

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

DANA BOUCEK (NPI 1154612117) is an individual pediatric cardiology provider in Salt Lake City, Utah, licensed in Pennsylvania (MD460722) and active in the NPI registry since April 2011. She is enrolled in Medicare PECOS, maintains a secondary practice location in Phildelphia, and is a graduate of University Of Colorado School Of Medicine, Denver (2011).

NPPES Registry Identity

NPI1154612117
Entity TypeIndividualFemale
Primary Taxonomy2080P0202X
Provider Legal NameDANA BOUCEK
Location Address100 NORTH MARIO CAPECCHI DR., PRIMARY CHILDREN'SSalt Lake City, UT 84113
Mailing Address3601 Market St Unit 1713Philadelphia, PA 19104-5914 · (303) 746-7692
Sole ProprietorYes
Medical School CMSUniversity Of Colorado School Of Medicine, DenverGraduated 2011
Enumeration DateApril 26, 2011
Last NPPES UpdateOctober 28, 20212 updates tracked since enumeration
NPPES CertifiedOctober 28, 2021
NPI 1154612117 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPediatrics · Pediatric CardiologyAllopathic & Osteopathic Physicians
Taxonomy Code2080P0202X
License Licensed in PA · MD460722
Definition

A pediatric cardiologist provides comprehensive care to patients with cardiovascular problems. This specialist is skilled in selecting, performing and evaluating the structural and functional assessment of the heart and blood vessels, and the clinical evaluation of cardiovascular disease.

100 NORTH MARIO CAPECCHI DR., Salt Lake City, UT 84113

Secondary Practice Location 1

Location 13401 Civic Center Blvd, Division of Pediatric CardiologyPhildelphia, PA 19104 · Phone (215) 590-3274

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Dana Boucek 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 ID2961634977
PECOS Enrollment IDI20190320000741
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.

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 Dana Boucek's NPI number?

The NPI number for Dana Boucek is 1154612117. It was assigned to this individual provider in the NPPES registry on April 26, 2011.

Where is Dana Boucek located?

Dana Boucek practices at 100 North Mario Capecchi Dr. Primary Children's, Salt Lake City, UT 84113. The listed phone number is (801) 662-5700.

What is Dana Boucek's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Pediatric Cardiology, with taxonomy code 2080P0202X.

Is Dana Boucek enrolled in Medicare?

Yes. Dana Boucek 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.

What insurance does Dana Boucek accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Dana Boucek 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 Dana Boucek was last updated on October 28, 2021. NPI Profile syncs with the weekly NPPES data releases published by CMS.