Dr Axel Bouchard, PHD is a medicare enrolled "Clinical Neuropsychologist" provider in Fort Myers, Florida. His current practice location is
13099 S Cleveland Ave Ste 300, Fort Myers, Florida. You can reach out to his office (for appointments etc.) via phone at
(239) 936-1336.
Dr Axel Bouchard is licensed to practice in Florida (license number PY10473) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1962889139.
Healthcare Provider's Profile
Full Name | Dr Axel Bouchard |
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Gender | Male |
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Speciality | Clinical Neuropsychologist |
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Location | 13099 S Cleveland Ave Ste 300, Fort Myers, Florida |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1962889139
- Provider Enumeration Date: 04/27/2015
- Last Update Date: 08/20/2019
Medicare PECOS Information:
- PECOS PAC ID: 2365705761
- Enrollment ID: I20180418000402
Medical Identifiers
Medical identifiers for Dr Axel Bouchard such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1962889139 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
103T00000X | Psychologist | PY10473 (Florida) | Secondary |
103G00000X | Clinical Neuropsychologist | PY10473 (Florida) | Primary |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Axel Bouchard allows following entities to bill medicare on his behalf.
Entity Name | Madonna Rehabilitation Hospital |
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Entity Type | Part B Supplier - Clinic/group Practice |
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Entity Identifiers | NPI Number: 1417045642 PECOS PAC ID: 0446164081 Enrollment ID: O20031118000079 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Axel Bouchard is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Dr Axel Bouchard, PHD 13099 S Cleveland Ave Ste 300, Fort Myers, FL 33907-3835 Ph: () - | Dr Axel Bouchard, PHD 13099 S Cleveland Ave Ste 300, Fort Myers, FL 33907-3835 Ph: (239) 936-1336 |
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