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DR. JOHN MARK BOUCHILLON M.D.
NPI 1386030476
Pediatrics in Peterson Afb, CO

Active since April 15, 2015PECOS Enrolled
559 VINCENT ST, ATTN: 21 HCOS/SGOC - PEDIATRICS, PETERSON AFB, CO 80914(719) 556-1197(877) 813-1756 Get Directions Write a Review

NPPES record last updated: September 12, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. John Mark Bouchillon M.d. NPPES

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

DR. JOHN MARK BOUCHILLON M.D. (NPI 1386030476) is an individual pediatrics provider in Peterson Afb, Colorado, licensed in Alabama (MD.35462) and active in the NPI registry since April 2015. He is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1386030476
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameDR. JOHN MARK BOUCHILLONCredential: M.D.
Location Address559 VINCENT ST, ATTN: 21 HCOS/SGOC - PEDIATRICSPeterson Afb, CO 80914-1540
Mailing Address559 Vincent St, Attn: 21 Hcos/sgoc - PediatricsPeterson Afb, CO 80914-1540 · (719) 556-1197 · Fax (877) 813-1756
Phone(719) 556-1197
Fax(877) 813-1756
Sole ProprietorNo
Enumeration DateApril 15, 2015
Last NPPES UpdateSeptember 12, 2019
✔ NPI 1386030476 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in AL · MD.35462
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
559 VINCENT ST, Peterson Afb, CO 80914
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Dr. John Mark Bouchillon 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.

Medicare Billing Reassignment

Medicare enrollment records show John Bouchillon reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

University Of Alabama Health Services Foundation, PC
1,058 mi
Clinical Medical Laboratory
720 20TH ST S
Birmingham, AL 35233
  • Reassigned Medicare billing, Alabama enrollment
  • 4,494 clinicians in this Medicare group
NPI 1164617205 (205) 934-4983

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

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 80914 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
$89.43 typical visit price
range $58.06 – $174.82
Typical copayment $22.35 (range $14.51 – $43.70)
Most-billed visit code 99203
Established Patient
$102.03 typical visit price
range $18.88 – $142.79
Typical copayment $25.50 (range $4.72 – $35.69)
Most-billed visit code 99214
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.

KRYSTIN HUST DPT
Physical Therapist
559 VINCENT ST
PETERSON AFB, CO 80914
El Paso County (719) 524-2273
JAMES NEAL SUTHERLAND DDS
Dentist
559 VINCENT ST
PETERSON AFB, CO 80914
El Paso County (719) 556-1060
WAYNE ERWIN GRABOW DENTIST DDS
Dentist
559 VINCENT ST, 21 DS/SGGD-DENTAL CLINIC
PETERSON AFB, CO 80914
El Paso County (719) 556-1333
MICHELLE MONTGOMERY WHNP
Nurse Practitioner (Women's Health)
559 VINCENT ST, FAMILY PRACTICE CLINIC
PETERSON AFB, CO 80914
El Paso County (719) 556-1080
MEREDITH L FAAS LCSW
Social Worker (Clinical)
559 VINCENT ST
COLORADO SPRINGS, CO 80914
El Paso County (719) 357-8957
MR. RYAN S OGILVY MSW, LCSW
Social Worker (Clinical)
559 VINCENT ST, ATTN: 21MDOS/SGOW- MENTAL HEALTH
PETERSON AFB, CO 80914
El Paso County (719) 556-7804
ALICIA TERESA ROZYCKI PH.D.
Psychologist (Counseling)
559 VINCENT ST, ATTN: 21 MDS - SGOF
PETERSON AFB, CO 80914
El Paso County (719) 567-4489
DR. LOUIS A PAGANO JR. PH.D.
Psychologist (Counseling)
559 VINCENT ST, ATTN: 21 MDS/SGOW-MENTAL HEALTH
PETERSON AFB, CO 80914
El Paso County (719) 526-8873

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 John Bouchillon's NPI number?

The NPI number for John Bouchillon is 1386030476. It was assigned to this individual provider in the NPPES registry on April 15, 2015.

Where is John Bouchillon located?

John Bouchillon practices at 559 Vincent St Attn: 21 Hcos/Sgoc - Pediatrics, Peterson Afb, CO 80914. The listed phone number is (719) 556-1197.

What is John Bouchillon's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is John Bouchillon enrolled in Medicare?

Yes. John Bouchillon is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for John Bouchillon's services?

According to the CMS Revalidation Reassignment List (October 2026 release), John Bouchillon reassigns Medicare benefits to University Of Alabama Health Services Foundation, PC (Birmingham, AL). 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 John Bouchillon's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for John Bouchillon was last updated on September 12, 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.