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Jeffrey Loberiano Boucher, PMHNP

NPI 1124973938ActiveIndividual· Nurse Practitioner, Psych/Mental Health· Old Town, ME

Nurse Practitioner, Psych/Mental Health (PMHNP) in Old Town, Maine, licensed in CA, with an NPI issued in February 2026. Enrolled in Medicare as practitioner - nurse practitioner.

Overview

NPI1124973938
StatusActive
Entity typeIndividual
CredentialPMHNP
Sole proprietorNo
NPI issuedFeb 27, 2026
Last updated in NPPESFeb 27, 2026
Certified by providerFeb 27, 2026

Specialties and licenses

TaxonomyCodeLicenseState
Nurse Practitioner, Psych/Mental Health Primary363LP0808X95038702CA

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Oct 9, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 10, 2026No match—
New York OMIG · Nov 10, 2026No match—
Ohio Medicaid · Nov 10, 2026No match—
Pennsylvania Medicheck · Nov 10, 2026No match—
Washington HCA · Nov 10, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Enrolled Practitioner - Nurse Practitioner (ME)

Medicare sources and data years

Education and affiliations

Graduation year2025
Medicare specialtyNurse Practitioner

Source: CMS Care Compare

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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