LISA BOUCEK (NPI# 1720498975) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1720498975 |
| Entity Type | Individual |
| Full Name | LISA BOUCEK |
| Credential | M.D. |
| Practice Address |
21807 N Scottsdale Rd Scottsdale AZ 85255 |
| Mailing Address |
9827 N 95th St Ste 105 Scottsdale AZ 85258-4591 |
| Practice Telephone | 4808608488 |
| Practice Fax Number | 4808608498 |
| Mailing Telephone | 4808608488 |
| Enumeration Date | 2014-04-28 |
| Last Update Date | 2019-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2080A0000X |
Pediatrics Specialization: Adolescent Medicine |
54432 | AZ | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1919 E Thomas Rd, Phoenix Children's Hospital, Phoenix, AZ 850167710 | 6025462923 |
| Street Address |
21807 N SCOTTSDALE RD |
| City | SCOTTSDALE |
| State | AZ |
| Zip Code | 85255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982890588 | Erin Keely Lanphier | Psychologist | 21807 N Scottsdale Rd, Scottsdale, AZ 85255-7439 | 2007-09-18 |
| 1407275837 | Tyler Dirvonas | Pediatrics | 21807 N Scottsdale Rd, Scottsdale, AZ 85255-7439 | 2014-04-14 |
| 1972820025 | Jennifer Michelle Cropp | Pediatrics | 21807 N Scottsdale Rd, Scottsdale, AZ 85255-7439 | 2010-04-29 |
| 1689804213 | Good Night Pediatrics East Valley PC | Clinic/Center | 21807 N Scottsdale Rd, Scottsdale, AZ 85255-7439 | 2009-07-16 |
| 1003084682 | Sherry Patricia Pottgen | Pediatrics | 21807 N Scottsdale Rd, Scottsdale, AZ 85255-7439 | 2008-02-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417427865 | Inpatient Health LLC | Internal Medicine | 17470 Pacesetter Way, Scottsdale, AZ 85255 | 2018-11-28 |
| 1003391764 | Daniel Andrew Wool | Family Medicine | 20801 N Scottsdale Rd Suite 205, Scottsdale, AZ 85255 | 2018-09-28 |
| 1225533953 | Nona Lynel Dasenbrock | Dietitian, Registered | 10912 E Butherus Dr, Scottsdale, AZ 85255 | 2018-03-26 |
| 1376044248 | Brandon A Hunter | Physician Assistant | 17300 N Perimeter Dr, Ste 150, Scottsdale, AZ 85255 | 2018-02-26 |
| 1235644048 | Harmony Dental Partners, LLC | Dentist | 21809 N. Scottsdale Rd., Suite C105, Scottsdale, AZ 85255 | 2017-12-04 |
| 1093226698 | Brenda Renee Junior | Family Medicine | 7920 E Thompson Peak Pkwy Ste 100, Scottsdale, AZ 85255 | 2017-10-23 |
| 1740790393 | Sanus Dme LLC | Durable Medical Equipment & Medical Supplies | 17300 N Perimeter Dr, Ste 150, Scottsdale, AZ 85255 | 2017-10-10 |
| 1235651894 | Jill Walker | Physical Therapist | 7900 E. Princess, Apt. 1063, Scottsdale, AZ 85255 | 2017-07-14 |
| 1780123000 | Mcdowell Smile Life Dentistry LLC | Dentist | 10401 E. Mcdowell Mountain Ranch Rd Ste 130, Scottsdale, AZ 85255 | 2017-02-20 |
| 1942691779 | Gregory Edin | Dentist | 11550 E Paradise Lane, Scottsdale, AZ 85255 | 2015-02-16 |
| Find all providers in zip 85255 | ||||
| Taxonomy Code | 2080A0000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| Specialization | Adolescent Medicine |
| A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255544987 | Jeffrey Siegel | Pediatrics | 10200 N 92nd St Ste 150, Scottsdale, AZ 85258-4535 | 2007-05-08 |
| 1124405725 | Katherine Courtney Conover | Pediatrics | 9827 N 95th St Ste 105, Scottsdale, AZ 85258 | 2015-05-03 |
| 1972820025 | Jennifer Michelle Cropp | Pediatrics | 21807 N Scottsdale Rd, Scottsdale, AZ 85255-7439 | 2010-04-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1114271798 | Kristen Marie Buchanan | Pediatrics | 4700 N 51st Ave Ste 4, Phoenix, AZ 85031-1237 | 2012-11-02 |
| 1992060222 | Patti J. Perry, M.d. PC | Pediatrics | 1832 S. 8th Avenue, Yuma, AZ 85364 | 2012-07-12 |
| 1952626053 | Joseph King Hindman | Pediatrics | 8375 Koch Field Rd, Flagstaff, AZ 86004-1255 | 2010-03-31 |
| 1669679098 | Stefanie Ann Workman | Pediatrics | 2929 N Power Rd, Suite 101, Mesa, AZ 85215-1745 | 2007-06-29 |
| 1295930980 | Mary Ellen Rimsza | Pediatrics | 518 S 3rd St, Phoenix, AZ 85004-2506 | 2007-06-20 |
| 1629296249 | Good Night Pediatrics East Valley PC | Pediatrics | 1452 N Higley Rd, Gilbert, AZ 85234-1600 | 2007-04-20 |
| 1508957101 | John Curley | Pediatrics | 4434 N 12th St, Phoenix, AZ 85014-4507 | 2006-09-27 |
| 1780775395 | Shannon Forshey | Pediatrics | 4434 N 12th Street, Phoenix, AZ 85014-1101 | 2006-09-27 |
| 1194816702 | Brad Golner | Pediatrics | 4735 E Union Hills Dr, Phoenix, AZ 85050-3362 | 2006-09-27 |
| 1093733644 | Rumbha Virasoontara Bhandhusavee | Pediatrics | 13980 N 67th Ave, Suite Number 1, Glendale, AZ 85306-3715 | 2006-07-18 |
| Find all providers with the same taxonomy | ||||
| City | SCOTTSDALE |
| Zip Code | 85255 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.