DR. GLEN MICHAEL BOUCHARD (D.O.) – Emergency Medicine Physician, NPI 1790751667

DR. GLEN MICHAEL BOUCHARD (D.O.) is a healthcare provider. based in Springfield, Massachusetts. specializing in EMERGENCY MEDICINE. They hold the professional credentials D.O.. They hold a License No. 000446 (CT). The NPI Number for DR. GLEN MICHAEL BOUCHARD (D.O.) is 1790751667

Main info

Male
41 Years Of Experience
Accepts Medicare Assignment
Name
DR. GLEN MICHAEL BOUCHARD (D.O.)
NPI
1790751667
Phone
(413) 794-5700
Address
280 CHESTNUT ST
Enumeration Date
28 February 2006
Last Update Date
10 December 2015

Doctor Profile

Medical School Name
PHILADELPHIA COLLEGE OF OSTEOPATHIC MEDICINE
Secondary Phone
4137945439
Graduation Year
1985 (41 years ago)
PAC ID
9739103227
Group Practice PAC ID
5991602971
Professional Enrollment ID
I20061227000125
Address ID
MA011991001SP759XXSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience63
Completeness75
Years active:20State licenses:2Digital endpointsOther names

1,682 EMERGENCY MEDICINE in MA

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Provider Addresses for DR. GLEN MICHAEL BOUCHARD (D.O.)

  • 280, Chestnut Street, Metro Center, Springfield, Hampden County, Massachusetts, 01103, United States

    2ND FLOOR

    SPRINGFIELD, MA 011991619

    Phone: (413) 794-5700

    Type: Mailing

  • Wing Memorial Hospital, 40, Wright Street, Palmer Green Estates, Palmer, Hampden County, Massachusetts, 01069, United States

    PALMER, MA 010691138

    Phone: (413) 284-5308

    Fax: (413) 284-5413

    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: 2006-12-27

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
I20061227000125IEmergency MedicineMATBD

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
99285Emergency department visit with high level of medical decision making171165$0
99284Emergency department visit with moderate level of medical decision making7169$0
99283Emergency department visit with low level of medical decision making1818$0
View full utilization report →

Insurance plans in this area (ZIP 01199)

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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: 5991602971View full group profile

Reviews

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Frequently asked questions

What federal number belongs to DR. GLEN MICHAEL BOUCHARD (D.O.)?
The federal identifier for DR. GLEN MICHAEL BOUCHARD (D.O.) is NPI 1790751667.
Is DR. GLEN MICHAEL BOUCHARD (D.O.)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
Can you summarize DR. GLEN MICHAEL BOUCHARD (D.O.)'s specialty in plain language?
Clinically, the directory lists DR. GLEN MICHAEL BOUCHARD (D.O.) with Emergency Medicine Physician. Clinical services aligned with this taxonomy classification.
What location metadata exists for DR. GLEN MICHAEL BOUCHARD (D.O.)?
The page summarizes Springfield, Massachusetts for DR. GLEN MICHAEL BOUCHARD (D.O.); expand the address list for detail.
How can I contact DR. GLEN MICHAEL BOUCHARD (D.O.)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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