ALEXANDER ALBERT BOUCHER (NPI# 1194083675) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1194083675 |
| Entity Type | Individual |
| Full Name | ALEXANDER ALBERT BOUCHER |
| Credential | M.D. |
| Practice Address |
909 Fulton St Se Minneapolis MN 55455-4800 |
| Practice Telephone | 6126727422 |
| Enumeration Date | 2012-05-02 |
| Last Update Date | 2019-07-11 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
57181 | MN | Allopathic & Osteopathic Physicians |
| N | 2080P0207X |
Pediatrics Specialization: Pediatric Hematology-Oncology |
35.128089 | OH | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MN | 1194083675 | 05 |
| Street Address |
909 FULTON ST SE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55455-4800 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558365122 | Gary L Bryant | Internal Medicine | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2005-06-10 |
| 1437756848 | Kelsey Larsen | Pharmacist | 909 Fulton St Se, Attn: 1st Floor Pharmacy 1.273, Minneapolis, MN 55455-4800 | 2020-10-08 |
| 1518572254 | Rachel Elizabeth Kraemer | Audiologist | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2020-09-10 |
| 1912527268 | Becca Marie Mahnesmith | Nurse Practitioner | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2020-04-16 |
| 1073142212 | Emily Kline | Health Educator | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2020-04-08 |
| 1689200024 | Zach Rivers | Pharmacist | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2020-03-17 |
| 1518506138 | Carrie Leigh Kwiatkowski | Specialist/Technologist | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2019-12-30 |
| 1801432414 | Abigail Denise Conrad | Physician Assistant | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2019-11-19 |
| 1700428497 | Ashley Herman | Dietitian, Registered | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2019-10-14 |
| 1104471275 | Holly Heewon Lee | Genetic Counselor, MS | 909 Fulton St Se, Minneapolis, MN 55455-4800 | 2019-08-06 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932715679 | Kara Biscobing | Nurse Anesthetist, Certified Registered | M Health Fairview Ummc East Bank 3-307, 500 Harvard Street, Minneapolis, MN 55455 | 2020-09-18 |
| 1982213237 | Yue Hu | Dentist | 515 Delaware St. Se Malcolm Moos Health Sciences Tower, Room 7-174, Minneapolis, MN 55455 | 2020-07-23 |
| 1952922148 | Jacob Laurence Tigner | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se, Mmc 284, Minneapolis, MN 55455 | 2020-04-29 |
| 1710507538 | Rachael Grundman | Student in an Organized Health Care Education/Training Program | 420 Delaware St, Mmc 395, Minneapolis, MN 55455 | 2020-04-22 |
| 1497375240 | Sanjay Dhawan | Student in an Organized Health Care Education/Training Program | 420 Delaware St. Se, Mmc 195, Minneapolis, MN 55455 | 2020-04-22 |
| 1508486549 | Dariel Andres Diaz | Student in an Organized Health Care Education/Training Program | 420 Se Delaware Street, Mmc 195, Minneapolis, MN 55455 | 2020-04-20 |
| 1275186280 | Kerem Ozturk | Radiology | B-226 Mayo Memorial Building, Mmc 292 420 Delaware Street S.e., Minneapolis, MN 55455 | 2019-07-18 |
| 1275194631 | Andres Jose Gonzalez Coba | Student in an Organized Health Care Education/Training Program | 420 Delaware Street Se Mmc 284, Minneapolis, MN 55455 | 2019-06-26 |
| 1841850278 | Brendan Andrew Schleyer | Dentist | 515 Delaware St Se, Div of Periodontology, Moos Tower, 7-368, Minneapolis, MN 55455 | 2019-06-18 |
| 1932767399 | Claire-audrey Y Bayan | Student in an Organized Health Care Education/Training Program | 420 Delaware Street, Mmc 98, Minneapolis, MN 55455 | 2019-05-31 |
| Find all providers in zip 55455 | ||||
| Taxonomy Code | 2080P0207X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Pediatric Hematology-Oncology |
| A pediatrician trained in the combination of pediatrics, hematology and oncology to recognize and manage pediatric blood disorders and cancerous diseases. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) was provided by the American Osteopathic Board of Pediatrics. The Certification is no longer offered. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720058043 | Christopher L Moertel | Pediatrics | 2450 Riverside Ave., East Building, Ninth Floor, Minneapolis, MN 55454 | 2006-01-26 |
| 1013250836 | Asmaa Ferdjallah | Pediatrics | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2013-03-29 |
| 1568755965 | Robin Lesley Williams | Pediatrics | 2450 Riverside Ave, Department of Pediatrics, Minneapolis, MN 55454-1450 | 2011-05-18 |
| 1194036889 | Baheyeldin M Salem | Pediatrics | 2900 Thomas Ave S, Apt # 2230, Minneapolis, MN 55416-4477 | 2010-06-28 |
| 1245557867 | Nathan Gossai | Pediatrics | 420 Delaware St Se, Mmc 391, Minneapolis, MN 55455-0341 | 2010-04-21 |
| 1467626259 | Mary Margaret Skrypek | Pediatrics | 2530 Chicago Ave, Children's Specialty Center Suite 175, Minneapolis, MN 55404-4289 | 2008-04-14 |
| 1275707937 | Stephanie Ann Fritch Lilla | Pediatrics | 2525 Chicago Ave, Minneapolis, MN 55404-4518 | 2008-04-14 |
| 1538357785 | Troy Christopher Lund | Pediatrics | 420 Delaware St Se, Minneapolis, MN 55455-0341 | 2007-10-11 |
| 1538369871 | Emily Greengard | Pediatrics | 2450 Riverside Ave Se, East Building Journey Clinic 9e, Minneapolis, MN 55454 | 2007-07-24 |
| 1386846095 | Christen Ebens | Pediatrics | 2450 Riverside Ave, Journey Clinic, 9th Floor, East Building, Minneapolis, MN 55454-1450 | 2007-06-04 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55455 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.