MR. REID ELLIOT BOUCHARD (DPT) – Physical Therapist, NPI 1104253855

MR. REID ELLIOT BOUCHARD (DPT) is a healthcare provider. based in San diego, California. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. They hold a License No. PT40403 (CA). The NPI Number for MR. REID ELLIOT BOUCHARD (DPT) is 1104253855

Main info

Male
13 Years Of Experience
Accepts Medicare Assignment
Name
MR. REID ELLIOT BOUCHARD (DPT)
NPI
1104253855
Phone
(858) 722-1884
Address
10835 ELDERWOOD RD
Enumeration Date
26 September 2013
Last Update Date
19 August 2021

Doctor Profile

Medical School Name
CREIGHTON UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
7607249000
Graduation Year
2013 (13 years ago)
PAC ID
8729217179
Group Practice PAC ID
1153388434
Professional Enrollment ID
I20140204001811
Address ID
CA920816056VI1958XCTRX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience48
Completeness75
Years active:12State licenses:1Digital endpointsOther names

9,449 PHYSICAL THERAPIST IN PRIVATE PRACTICE in CA

Provider Addresses for MR. REID ELLIOT BOUCHARD (DPT)

  • 10835 ELDERWOOD RD

    SAN DIEGO, CA 921311559

    Phone: (858) 722-1884

    Type: Mailing

  • 3905 WARING RD

    OCEANSIDE, CA 920564405

    Phone: (760) 724-9000

    Fax: (760) 724-3686

    Type: Location

  • 1958 VIA CTR

    VISTA, CA 920816056

    Phone: (760) 724-9000

    Fax: (760) 724-3686

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2014-02-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20140204001811IPhysical Therapist In Private PracticeCATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes2,095155$0
97530Therapy procedure using functional activities1,31983$0
G0283Electrical stimulation (unattended), to one or more areas for indication(s) other than wound care, as part of a therapy plan of care42654$0
97750Test or measurement for functional capacity, each 15 minutes15888$0
97016Application of blood vessel compression device14132$0
View full utilization report →

Insurance plans in this area (ZIP 92131)

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Provider's Procedures

MR. REID ELLIOT BOUCHARD (DPT) performs procedures in PHYSICAL THERAPIST IN PRIVATE PRACTICE. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYCA97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes646119

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 1153388434View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeCA
Physician AssistantCA
Physical Therapist In Private PracticeCA
Physician AssistantCA
Physician AssistantCA
Physical Medicine And RehabilitationNC
-CA
Physical Therapist In Private PracticeCA
Orthopedic SurgeryCA
Orthopedic SurgeryCA

Reviews

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Frequently asked questions

Can I use this page to confirm MR. REID ELLIOT BOUCHARD (DPT)'s NPI?
Yes. MR. REID ELLIOT BOUCHARD (DPT) is listed with NPI 1104253855 in the public NPI dataset.
Does CMS list MR. REID ELLIOT BOUCHARD (DPT) as active?
Yes — MR. REID ELLIOT BOUCHARD (DPT) is active in the NPI listing used on this page.
What is MR. REID ELLIOT BOUCHARD (DPT)'s primary classification?
Physical Therapist is the headline specialty for MR. REID ELLIOT BOUCHARD (DPT) here. Clinical services aligned with this taxonomy classification.
What address line appears for MR. REID ELLIOT BOUCHARD (DPT)?
MR. REID ELLIOT BOUCHARD (DPT)'s geographic hint is San Diego, California in our summary view.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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