KLAYME-SHANE BOUCHER DO
NPI 1689317141
Internal Medicine in San Antonio, TX

Q: What is Klayme-shane Boucher's NPI number?

The NPI number for Klayme-shane Boucher is 1689317141. It was assigned to this individual provider in the NPPES registry on April 13, 2022.

Q: What is Klayme-shane Boucher's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Active since April 13, 2022PECOS EnrolledAccepts Medicare Assignment

12446 WEST AVE STE 200, SAN ANTONIO, TX 78216(210) 525-1668 Get Directions Write a Review

NPPES record last updated: July 12, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 12, 2025, Jun 12, 2025, Apr 14, 2022 (3 updates tracked since 2022).

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About Klayme-shane Boucher Do NPPES

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

KLAYME-SHANE BOUCHER DO (NPI 1689317141) is an individual internal medicine provider in San Antonio, Texas, licensed in Texas (V8588) and active in the NPI registry since April 2022. He is enrolled in Medicare PECOS, is affiliated with Methodist Hospital, and maintains a secondary practice location in San Antonio.

NPPES Registry Identity

NPI1689317141

Entity TypeIndividualMale

Primary Taxonomy207R00000X

Provider Legal NameKLAYME-SHANE BOUCHERCredential: DO

Location Address12446 WEST AVE STE 200San Antonio, TX 78216-2530

Mailing Address12446 West Ave Ste 200San Antonio, TX 78216-2530 · (210) 525-1668

Phone(210) 525-1668

Sole ProprietorNo

Medical School CMSOtherGraduated 2022

Enumeration DateApril 13, 2022

Last NPPES UpdateJuly 12, 20253 updates tracked since enumeration

NPPES CertifiedJuly 12, 2025

✔ NPI 1689317141 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207R00000X

License✔ Licensed in TX · V8588

Definition

A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.

Also ListedHospitalistTaxonomy 208M00000X · License V8588 (TX)

12446 WEST AVE STE 200, San Antonio, TX 78216

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Secondary Practice Location 1

Location 14502 Medical DrSan Antonio, TX 78229-4402 · Phone (210) 358-3555

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Texas.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

Klayme-shane 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 ID9638680366

PECOS Enrollment IDI20250618002410

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.

Methodist Hospital

Acute Care Hospitals · San Antonio, TX

4/5 CMS rating

OwnershipProprietary

CMS Certification Number450388

Location7700 Floyd Curl DrSan Antonio, TX 78229 · Bexar County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 78216 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

$126.40 typical visit price

range $54.84 – $166.88

Typical copayment $31.60 (range $13.71 – $41.72)

Most-billed visit code 99204

Established Patient

$97.05 typical visit price

range $17.52 – $136.11

Typical copayment $24.26 (range $4.38 – $34.02)

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.

JEFFREY WOODS

Internal Medicine (Pulmonary Disease)