Dominica Boucher
NPI 1104615087ActiveIndividual· Nurse Practitioner· Worcester, MA
Nurse Practitioner with Umass Memorial Medical Group Inc, practicing in Worcester, Massachusetts. Enrolled in Medicare as practitioner - nurse practitioner. Lists Umass Memorial Medical Center/University Campus as a hospital affiliation.
Overview
| NPI | 1104615087 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Sole proprietor | No |
| NPI issued | May 6, 2025 |
| Last updated in NPPES | Jun 5, 2025 |
| Certified by provider | Jun 5, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | RN2371640 | MA |
| Nurse Practitioner, Acute Care | 363LA2100X | RN2371640 | MA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (MA) |
|---|
Education and affiliations
| Graduation year | 2024 |
|---|---|
| Medicare specialty | Nurse Practitioner |
Medical group
- Umass Memorial Medical Group IncWorcester, MA · 2,516 clinicians
Hospital affiliation
- Umass Memorial Medical Center/University CampusWorcester, MA
Industry payments (Open Payments)
None reported for 2025 or 2024.
Receiving payments does not imply wrongdoing. What Open Payments covers ·original records
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