Mallory Jannelle Boucher, NP
NPI 1336945161ActiveIndividual· Nurse Practitioner· Rochester, MN
Nurse Practitioner (NP) with Mayo Clinic, practicing in Rochester, Minnesota. Enrolled in Medicare as practitioner - nurse practitioner.
Overview
| NPI | 1336945161 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | NP |
| Sole proprietor | No |
| NPI issued | Feb 21, 2025 |
| Last updated in NPPES | Jun 25, 2025 |
| Certified by provider | Jun 25, 2025 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Nurse Practitioner Primary | 363L00000X | 12869 | MN |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Nurse Practitioner (MN) |
|---|
Education and affiliations
| Graduation year | 2025 |
|---|---|
| Medicare specialty | Nurse Practitioner |
| Telehealth | Offers telehealth |
Medical group
- Mayo ClinicRochester, MN · 4,956 clinicians
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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