DR. GLEN MICHAEL BOUCHARD D.O.
NPI 1790751667
Emergency Medicine in Palmer, MA
About Dr. Glen Michael Bouchard D.o. NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
DR. GLEN MICHAEL BOUCHARD D.O. (NPI 1790751667) is an individual emergency medicine provider in Palmer, Massachusetts, licensed in Massachusetts (78416) and active in the NPI registry since February 2006. He is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Dr. Glen Michael Bouchard D.o. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Glen Bouchard reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Springfield, MA 01199
- Reassigned Medicare billing, Massachusetts enrollment
- 1,537 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Areas of Expertise CMS Part B claims 3
Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 01069 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
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.
PALMER, MA 01069
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 Glen Bouchard's NPI number?
The NPI number for Glen Bouchard is 1790751667. It was assigned to this individual provider in the NPPES registry on February 28, 2006.
Where is Glen Bouchard located?
Glen Bouchard practices at 40 Wright St, Palmer, MA 01069. The listed phone number is (413) 284-5308.
What is Glen Bouchard's specialty?
The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.
Is Glen Bouchard enrolled in Medicare?
Yes. Glen Bouchard is registered in the Medicare PECOS enrollment system.
Which organization bills Medicare for Glen Bouchard's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Glen Bouchard reassigns Medicare benefits to Baystate Medical Practices, Inc (Springfield, MA). 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 Glen Bouchard'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 Glen Bouchard was last updated on December 10, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Dr. Glen Michael Bouchard, D.O. · NPI 1790751667
Emergency Medicine physician in Palmer, Massachusetts. Individual provider, active in the CMS NPPES registry since February 28, 2006.
## Identity
- **NPI:** 1790751667 (Entity type: Individual)
- **Enumerated:** February 28, 2006
- **Primary specialty:** Emergency Medicine · taxonomy 207P00000X
- **State license:** 78416 (Massachusetts)
- **Sole proprietor:** No
## Practice location
- **Address:** 40 WRIGHT ST, Palmer, MA 01069-1138
- **Phone:** (413) 284-5308 · **Fax:** (413) 284-5413
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Baystate Medical Practices, Inc (NPI 1548205909, Springfield, MA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 10, 2015
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Source: [NPI Profile](https://npiprofile.com/npi/1790751667) · Data from the CMS NPPES public registry.