DANA BOUCEK
NPI 1154612117
Pediatrics - Pediatric Cardiology in Salt Lake City, UT
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, is affiliated with University Of Utah Hospitals And Clinics, and maintains a secondary practice location in Phildelphia.
NPPES Registry Identity
Specialties & Licenses 2
Secondary Practice Location 1
Accepted Insurance
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
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.
Medicare Billing Reassignments
2Medicare enrollment records show Dana Boucek reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Salt Lake City, UT 84113
- Reassigned Medicare billing, Utah enrollment
- 751 clinicians in this Medicare group
Salt Lake City, UT 84132
- Reassigned Medicare billing, Utah enrollment
- 2,620 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Hospital Affiliations CMS Care Compare
Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.
University Of Utah Hospitals And Clinics
Acute Care Hospitals · Salt Lake City, UTFrequently 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.
Which organizations bill Medicare for Dana Boucek's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Dana Boucek reassigns Medicare benefits to 2 organizations: University Of Utah Pediatric Services (Salt Lake City, UT) and University Of Utah Adult Services (Salt Lake City, UT). 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 Dana Boucek's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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.
Is Dana Boucek affiliated with any hospitals?
According to CMS data, Dana Boucek is affiliated with University Of Utah Hospitals And Clinics.
When was this NPI record last updated?
The NPPES record for Dana Boucek was last updated on October 28, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.
# Dana Boucek · NPI 1154612117
Pediatric Cardiology physician in Salt Lake City, Utah. Individual provider, active in the CMS NPPES registry since April 26, 2011.
## Identity
- **NPI:** 1154612117 (Entity type: Individual)
- **Enumerated:** April 26, 2011
- **Primary specialty:** Pediatrics - Pediatric Cardiology · taxonomy 2080P0202X
- **State license:** MD460722 (Pennsylvania)
- **Sole proprietor:** Yes
## Practice location
- **Address:** 100 NORTH MARIO CAPECCHI DR., PRIMARY CHILDREN'S, Salt Lake City, UT 84113
- **Phone:** (801) 662-5700
## Medicare
- **Medicare:** Enrolled (PECOS); accepts Medicare assignment
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): University Of Utah Pediatric Services (NPI 1063876100, Salt Lake City, UT); University Of Utah Adult Services (NPI 1720482599, Salt Lake City, UT) · CMS Revalidation Reassignment List, October 2026 release
- **Medical school:** University Of Colorado School Of Medicine, Denver, class of 2011
## Record status
- **NPPES last updated:** October 28, 2021
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Source: [NPI Profile](https://npiprofile.com/npi/1154612117) · Data from the CMS NPPES public registry.