MELISSA KAY BOUCHER DO
NPI 1386222495
Family Medicine in Portland, OR

Active since March 30, 2021PECOS EnrolledAccepts Medicare Assignment
4920 N INTERSTATE AVE, PORTLAND, OR 97217(503) 215-3300 Get Directions Write a Review

NPPES record last updated: October 30, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Melissa Kay Boucher Do NPPES

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

MELISSA KAY BOUCHER DO (NPI 1386222495) is an individual family medicine provider in Portland, Oregon, licensed in Oregon (DO221767) and active in the NPI registry since March 2021. She is enrolled in Medicare PECOS, is affiliated with Providence Portland Medical Center, and is a graduate of Campbell Univ School Of Osteopathic Medicine (2021).

NPPES Registry Identity

NPI1386222495
Entity TypeIndividualFemale
Primary Taxonomy207Q00000X
Provider Legal NameMELISSA KAY BOUCHERCredential: DO
Location Address4920 N INTERSTATE AVEPortland, OR 97217-3653
Mailing AddressPo Box 3158Portland, OR 97208-3158 · (503) 215-6494
Sole ProprietorNo
Medical School CMSCampbell Univ School Of Osteopathic MedicineGraduated 2021
Enumeration DateMarch 30, 2021
Last NPPES UpdateOctober 30, 2024
NPPES CertifiedOctober 30, 2024
NPI 1386222495 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License Licensed in OR · DO221767
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
4920 N INTERSTATE AVE, Portland, OR 97217

Accepted 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

Melissa Kay Boucher Do 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 ID840721619
PECOS Enrollment IDI20241003002469
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.

Hospital Affiliations CMS Care Compare

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

Providence Portland Medical Center

Acute Care Hospitals · Portland, OR
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number380061
Location4805 NE Glisan StreetPortland, OR 97213 · Multnomah County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 97217 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
$90.51 typical visit price
range $58.99 – $176.88
Typical copayment $22.62 (range $14.74 – $44.22)
Most-billed visit code 99203
Established Patient
$103.51 typical visit price
range $19.32 – $144.79
Typical copayment $25.87 (range $4.83 – $36.19)
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.

Family Medicine
4920 N INTERSTATE AVE
PORTLAND, OR 97217
Family Medicine
4920 N INTERSTATE AVE
PORTLAND, OR 97217
Family Medicine
4920 N INTERSTATE AVE
PORTLAND, OR 97217
Psychologist (Clinical)
4920 N INTERSTATE AVE
PORTLAND, OR 97217
Family Medicine
4920 N INTERSTATE AVE
PORTLAND, OR 97217
Family Medicine
4920 N INTERSTATE AVE
PORTLAND, OR 97217
Family Medicine
4920 N INTERSTATE AVE
PORTLAND, OR 97217
Nurse Practitioner (Family)
4920 N INTERSTATE AVE
PORTLAND, OR 97217

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 Melissa Boucher's NPI number?

The NPI number for Melissa Boucher is 1386222495. It was assigned to this individual provider in the NPPES registry on March 30, 2021.

Where is Melissa Boucher located?

Melissa Boucher practices at 4920 N Interstate Ave, Portland, OR 97217. The listed phone number is (503) 215-3300.

What is Melissa Boucher's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Melissa Boucher enrolled in Medicare?

Yes. Melissa 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 Melissa Boucher accept?

Health plans from Moda Health Plan, Inc. and Providence Health Plan list Melissa 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 Melissa Boucher affiliated with any hospitals?

According to CMS data, Melissa Boucher is affiliated with Providence Portland Medical Center.

When was this NPI record last updated?

The NPPES record for Melissa Boucher was last updated on October 30, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.