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MASON CLARK BOUCHER
NPI 1154879781
Counselor - Mental Health in Portland, OR

Active since September 12, 2016PECOS Enrolled
2236 SE BELMONT ST, PORTLAND, OR 97214(503) 445-7699 Get Directions Write a Review

NPPES record last updated: May 15, 2020. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: May 15, 2020, Mar 23, 2020, Sep 12, 2016 (3 updates tracked since 2016).

About Mason Clark Boucher NPPES

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

MASON CLARK BOUCHER (NPI 1154879781) is an individual mental health provider in Portland, Oregon and active in the NPI registry since September 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1154879781
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMASON CLARK BOUCHER
Location Address2236 SE BELMONT STPortland, OR 97214-2817
Mailing AddressPo Box 8459Portland, OR 97207-8459
Phone(503) 445-7699
Sole ProprietorNo
Enumeration DateSeptember 12, 2016
Last NPPES UpdateMay 15, 20203 updates tracked since enumeration
NPPES CertifiedMay 15, 2020
✔ NPI 1154879781 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
2236 SE BELMONT ST, Portland, OR 97214
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mason Clark Boucher is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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 Mason Boucher reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Cascade Aids Project
Same address
Primary Care
2236 SE BELMONT ST
Portland, OR 97214
  • Reassigned Medicare billing, Oregon enrollment
  • 19 clinicians in this Medicare group
NPI 1275076168 (503) 278-3890

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

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BRIANNE BRINKLEY
Peer Specialist
2236 SE BELMONT ST
PORTLAND, OR 97214
Multnomah County (503) 445-7699
JOHN SKYLER JOHNSON-WAGNER
Peer Specialist
2236 SE BELMONT ST
PORTLAND, OR 97214
Multnomah County (503) 455-7699
NATHAN O MORALES
Counselor (Mental Health)
2236 SE BELMONT ST
PORTLAND, OR 97214
Multnomah County (503) 445-7699
EVAN RIAN JOHNSON
Nurse Practitioner (Family)
2236 SE BELMONT ST
PORTLAND, OR 97214
Multnomah County (503) 445-7699
CASCADE AIDS PROJECT
Clinic/Center (Primary Care)
2236 SE BELMONT ST
PORTLAND, OR 97214
Multnomah County (503) 278-3890
CRYSTAL NOEL PERRY MSC, MSW
Social Worker (Clinical)
2236 SE BELMONT ST
PORTLAND, OR 97214
Multnomah County (503) 445-7699
ALEXA MORRILL DNP, FNP-C
Nurse Practitioner (Family)
2236 SE BELMONT ST
PORTLAND, OR 97214
Multnomah County (503) 445-7699
LYNX DEMUTH CRM, CADC-I
Student in an Organized Health Care Education/Training Program
2236 SE BELMONT ST
PORTLAND, OR 97214
Multnomah County (503) 445-7699

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 Mason Boucher's NPI number?

The NPI number for Mason Boucher is 1154879781. It was assigned to this individual provider in the NPPES registry on September 12, 2016.

Where is Mason Boucher located?

Mason Boucher practices at 2236 SE Belmont St, Portland, OR 97214. The listed phone number is (503) 445-7699.

What is Mason Boucher's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Mason Boucher enrolled in Medicare?

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

Which organization bills Medicare for Mason Boucher's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mason Boucher reassigns Medicare benefits to Cascade Aids Project (Portland, OR). 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 Mason Boucher's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Mason Boucher accept?

Health plans from BridgeSpan Health Company, Kaiser Permanente, Moda Health Plan, Inc., PacificSource Health Plans and Regence BlueCross BlueShield of Oregon list Mason 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 Mason Boucher was last updated on May 15, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 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.