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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

LISA BOUCEK M.D.
NPI 1720498975
Pediatrics - Adolescent Medicine in Scottsdale, AZ

Active since April 28, 2014PECOS Enrolled
21807 N SCOTTSDALE RD, SCOTTSDALE, AZ 85255(480) 860-8488(480) 860-8498 Get Directions Write a Review

NPPES record last updated: September 1, 2026. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Sep 1, 2026, Jul 18, 2019 (2 updates tracked since 2019).

About Lisa Boucek M.d. NPPES

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

LISA BOUCEK M.D. (NPI 1720498975) is an individual adolescent medicine provider in Scottsdale, Arizona, licensed in Arizona (54432) and active in the NPI registry since April 2014. She is enrolled in Medicare PECOS and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1720498975
Entity TypeIndividualFemale
Primary Taxonomy2080A0000X
Provider Legal NameLISA BOUCEKCredential: M.D.
Location Address21807 N SCOTTSDALE RDScottsdale, AZ 85255
Mailing Address9827 N 95th St Ste 105Scottsdale, AZ 85258-4591 · (480) 860-8488
Phone(480) 860-8488
Fax(480) 860-8498
Sole ProprietorNo
Enumeration DateApril 28, 2014
Last NPPES UpdateSeptember 1, 20262 updates tracked since enumeration
NPPES CertifiedSeptember 1, 2026
✔ NPI 1720498975 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
License✔ Licensed in AZ · 54432
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
21807 N SCOTTSDALE RD, Scottsdale, AZ 85255
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Secondary Practice Locations 2

Location 11919 E Thomas Rd, Phoenix Children's HospitalPhoenix, AZ 85016-7710 · Phone (602) 546-2923
Location 22525 E Roosevelt StPhoenix, AZ 85008-4948 · Phone (833) 855-9973

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Ambetter from Arizona Complete Health, Ambetter Health, Antidote Health Plan of Arizona, Inc. and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Boucek 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 Reassignments

2

Medicare enrollment records show Lisa Boucek reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

District Medical Group, Inc
17 mi
Surgery
2525 E ROOSEVELT ST, MED CLINIC - INFECTIOUS DISEASE
Phoenix, AZ 85008
  • Reassigned Medicare billing, Arizona enrollment
  • 1,490 clinicians in this Medicare group
NPI 1174856280 (602) 344-1095
Maricopa County Special Health Care District
17 mi
Adult Mental Health
2525 E ROOSEVELT ST
Phoenix, AZ 85008
  • Reassigned Medicare billing, Arizona enrollment
  • 285 clinicians in this Medicare group
NPI 1205295581 (602) 344-8178

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

Other Providers at the Same Location NPPES 7

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

DR. SHERRY PATRICIA POTTGEN M.D.
Pediatrics
21807 N SCOTTSDALE RD
SCOTTSDALE, AZ 85255
Maricopa County (480) 425-8488
TYLER DIRVONAS MD
Pediatrics
21807 N SCOTTSDALE RD
SCOTTSDALE, AZ 85255
Maricopa County (480) 860-8488
DR. ALICE CHIEH JU SPEED MD
Pediatrics
21807 N SCOTTSDALE RD
SCOTTSDALE, AZ 85255
Maricopa County (480) 860-8488
ADRIENNE GOLDBERG KURLAND M.D.
Pediatrics
21807 N SCOTTSDALE RD
SCOTTSDALE, AZ 85255
Maricopa County (480) 860-8488
GOOD NIGHT PEDIATRICS EAST VALLEY PC
Clinic/Center (Urgent Care)
21807 N SCOTTSDALE RD
SCOTTSDALE, AZ 85255
Maricopa County (480) 237-5740
JENNIFER MICHELLE CROPP MD
Pediatrics (Adolescent Medicine)
21807 N SCOTTSDALE RD
SCOTTSDALE, AZ 85255
Maricopa County (480) 860-8488
ERIN KEELY LANPHIER PH.D.
Psychologist (Clinical Child & Adolescent)
21807 N SCOTTSDALE RD
SCOTTSDALE, AZ 85255
Maricopa County (480) 222-1575

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 Lisa Boucek's NPI number?

The NPI number for Lisa Boucek is 1720498975. It was assigned to this individual provider in the NPPES registry on April 28, 2014.

Where is Lisa Boucek located?

Lisa Boucek practices at 21807 N Scottsdale Rd, Scottsdale, AZ 85255. The listed phone number is (480) 860-8488.

What is Lisa Boucek's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Is Lisa Boucek enrolled in Medicare?

Yes. Lisa Boucek is registered in the Medicare PECOS enrollment system.

Which organizations bill Medicare for Lisa Boucek's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Boucek reassigns Medicare benefits to 2 organizations: District Medical Group, Inc (Phoenix, AZ) and Maricopa County Special Health Care District (Phoenix, AZ). Each 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 Lisa Boucek's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Boucek accept?

Health plans from Ambetter Health, Ambetter from Arizona Complete Health, Antidote Health Plan of Arizona, Inc., Blue Cross Blue Shield of Arizona and Cigna HealthCare of Arizona, Inc and 3 other insurers list Lisa Boucek 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.

When was this NPI record last updated?

The NPPES record for Lisa Boucek was last updated on September 1, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 59 days 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.