1. Home
  2. Directory
  3. Michigan
  4. Detroit
  5. Dermatology
  6. NPI Profile

DR. ALISON TISACK BOUCHER M.D.
NPI 1174887707
Dermatology in Detroit, MI

Active since June 28, 2012PECOS EnrolledAccepts Medicare Assignment
3031 W GRAND BLVD, DETROIT, MI 48202(313) 916-2151 Get Directions Write a Review

NPPES record last updated: February 24, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Dr. Alison Tisack Boucher M.d. NPPES

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

DR. ALISON TISACK BOUCHER M.D. (NPI 1174887707) is an individual dermatology provider in Detroit, Michigan, licensed in Michigan (4301101370) and active in the NPI registry since June 2012. She is enrolled in Medicare PECOS, is affiliated with Henry Ford Health Hospital, and maintains a secondary practice location in Dearborn.

NPPES Registry Identity

NPI1174887707
Entity TypeIndividualFemale
Primary Taxonomy207N00000X
Provider Legal NameDR. ALISON TISACK BOUCHERCredential: M.D.
Location Address3031 W GRAND BLVDDetroit, MI 48202-3046
Mailing Address606 N Gainsborough AveRoyal Oak, MI 48067-1939
Phone(313) 916-2151
Sole ProprietorNo
Medical School CMSWayne State University School Of MedicineGraduated 2012
Enumeration DateJune 28, 2012
Last NPPES UpdateFebruary 24, 2019
✔ NPI 1174887707 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
License✔ Licensed in MI · 4301101370
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
3031 W GRAND BLVD, Detroit, MI 48202
Open in Google Maps ↗

Secondary Practice Location 1

Location 118101 Oakwood BlvdDearborn, MI 48124-4089 · Phone (313) 436-2577

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and more.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

Dr. Alison Tisack Boucher M.d. 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 ID1456583178
PECOS Enrollment IDI20160727000293
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.

Areas of Expertise CMS Part B claims 8

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.

Destruction of precancer skin growth, 2-14 growths 17003
This procedure involves removing 2-14 precancerous skin growths. The growths are treated to prevent them from potentially developing into skin cancer. The process is safe, with minimal discomfort, and promotes healthier skin.
259 services45 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
73 services67 patients
Destruction of precancer skin growth, 1 growth 17000
"Destruction of precancer skin growth" is a procedure that eliminates a single precancerous skin growth. This is done to prevent it from developing into skin cancer. The growth may be removed using various methods such as cryotherapy (freezing), laser therapy, or topical medications.
70 services59 patients
Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
65 services58 patients
Destruction of skin growth, 1-14 growths 17110
"Destruction of skin growth" refers to a procedure where 1-14 abnormal skin growths are removed. This is done using methods such as freezing, burning, or laser therapy. It helps prevent the growth from causing discomfort or turning into a more serious condition.
55 services43 patients
Biopsy of related skin growth, first growth 11102
A biopsy of a skin growth involves taking a small sample of the growth to examine it under a microscope. This helps determine if the growth is harmful. The procedure is typically quick, with minimal discomfort. It's a crucial step in ensuring your skin's health.
39 services37 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Henry Ford Health Hospital

Acute Care Hospitals · Detroit, MI
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number230053
Location2799 W Grand BlvdDetroit, MI 48202 · Wayne County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 48202 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
$90.76 typical visit price
range $58.04 – $177.36
Typical copayment $22.69 (range $14.51 – $44.34)
Most-billed visit code 99203
Established Patient
$72.38 typical visit price
range $18.32 – $143.49
Typical copayment $18.09 (range $4.58 – $35.87)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

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

MRS. KAREN ANN WHITE RN, BSN, CDE
Registered Nurse (Diabetes Educator)
3031 W GRAND BLVD, SUITE 800
DETROIT, MI 48202
Wayne County (313) 916-7359
DR. SEMIRA VASANTI GOPIE M.B.B.S.
General Acute Care Hospital
3031 W GRAND BLVD, SUITE 800
DETROIT, MI 48202
Wayne County (313) 916-3761
CHANELL RENEE JAMES
Doula
3031 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
ASIA JOYNER CNM
Advanced Practice Midwife
3031 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2600
MS. KELLY ANN MANN MSN, FNP-BC, CDE
Nurse Practitioner (Family)
3031 W GRAND BLVD, SUITE 800 ENDO METAB
DETROIT, MI 48202
Wayne County (313) 916-3906
DR. LAURIE LINDEN KOHEN M.D.
Dermatology
3031 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2171
DAVID M. OZOG M.D.
Dermatology (MOHS-Micrographic Surgery)
3031 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-2454
SHOBANA SANKAR M.D
Internal Medicine (Rheumatology)
3031 W GRAND BLVD
DETROIT, MI 48202
Wayne County (313) 916-4824

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 Alison Boucher's NPI number?

The NPI number for Alison Boucher is 1174887707. It was assigned to this individual provider in the NPPES registry on June 28, 2012.

Where is Alison Boucher located?

Alison Boucher practices at 3031 W Grand Blvd, Detroit, MI 48202. The listed phone number is (313) 916-2151.

What is Alison Boucher's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Is Alison Boucher enrolled in Medicare?

Yes. Alison Boucher 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 Alison Boucher accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community and Priority Health list Alison 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.

Is Alison Boucher affiliated with any hospitals?

According to CMS data, Alison Boucher is affiliated with Henry Ford Health Hospital.

When was this NPI record last updated?

The NPPES record for Alison Boucher was last updated on February 24, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.