DR. KELLY MARIE BOUCHARD D.M.D.
NPI 1316105307
Dentist - General Practice in West Springfield, MA

Q: What is Kelly Bouchard's NPI number?

The NPI number for Kelly Bouchard is 1316105307. It was assigned to this individual provider in the NPPES registry on May 28, 2008.

Q: What is Kelly Bouchard's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Q: When was this NPI record last updated?

The NPPES record for Kelly Bouchard was last updated on May 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.

Active since May 28, 2008PECOS Enrolled

103 VAN DEENE AVE, WEST SPRINGFIELD, MA 01089(413) 733-3019(413) 788-7387 Get Directions Write a Review

NPPES record last updated: May 28, 2008. Verified against the NPPES registry weekly; last sync: August 02, 2026.

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About Dr. Kelly Marie Bouchard D.m.d. NPPES

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

DR. KELLY MARIE BOUCHARD D.M.D. (NPI 1316105307) is an individual general practice provider in West Springfield, Massachusetts, licensed in Massachusetts (20552) and active in the NPI registry since May 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1316105307

Entity TypeIndividualFemale

Primary Taxonomy1223G0001X

Provider Legal NameDR. KELLY MARIE BOUCHARDCredential: D.M.D.

Location Address103 VAN DEENE AVEWest Springfield, MA 01089-3200

Mailing Address103 Van Deene AveWest Springfield, MA 01089-3200 · (413) 733-3019 · Fax (413) 788-7387

Phone(413) 733-3019

Fax(413) 788-7387

Sole ProprietorNo

Enumeration DateMay 28, 2008

✔ NPI 1316105307 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDentist · General PracticeDental Providers

Taxonomy Code1223G0001X

License✔ Licensed in MA · 20552

Definition

A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

103 VAN DEENE AVE, West Springfield, MA 01089

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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. Kelly Marie Bouchard D.m.d. 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 01089 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

$90.70 typical visit price

range $58.86 – $177.36

Typical copayment $22.67 (range $14.71 – $44.34)

Most-billed visit code 99203

Established Patient

$73.22 typical visit price

range $19.11 – $144.84

Typical copayment $18.30 (range $4.77 – $36.21)

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 2

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

MS. KYLEEN RENEE KENTISH RDH

Dental Hygienist

103 VAN DEENE AVE
WEST SPRINGFIELD, MA 01089

Hampden County (413) 733-3019

ALEXA HOULE

Dental Hygienist

103 VAN DEENE AVE
WEST SPRINGFIELD, MA 01089

Hampden County (413) 733-3019

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 Kelly Bouchard's NPI number?

The NPI number for Kelly Bouchard is 1316105307. It was assigned to this individual provider in the NPPES registry on May 28, 2008.

Where is Kelly Bouchard located?

Kelly Bouchard practices at 103 Van Deene Ave, West Springfield, MA 01089. The listed phone number is (413) 733-3019.

What is Kelly Bouchard's specialty?

The primary specialty registered for this NPI is Dentist, specializing in General Practice, with taxonomy code 1223G0001X.

Is Kelly Bouchard enrolled in Medicare?

Yes. Kelly Bouchard is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Kelly Bouchard was last updated on May 28, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 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.