Catherine Jones Bordeaux, P.A.

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-07164 Issued in NC

Practice address

3030 Randolph Rd
Charlotte, NC 28211-1368

Phone

(704) 512-4450

NPI assigned

Oct 19, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 9

Medicare fee-for-service enrollment

Enrolled in NC, SC2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Physician Assistant

Education

Other, 2004

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Ubylee Healthcare Group, PLLCGroup PAC ID 8921349044, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: cbordeaux845597@direct.unc.nchie.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Ubylee Healthcare Group, PLLC

  • Specialist
  • Gastonia, NC
  • NPI 1700658036

  NC

  Medicare reassignment Care Compare group
• American Anesthesiology of North Carolina, PLLC

  • Pain Medicine (Anesthesiology) Physician
  • Monroe, NC
  • NPI 1174817993

  Physician Assistant, SC

  Medicare reassignment NPD
• American Anesthesiology of North Carolina, PLLC

  • Anesthesiology Physician
  • Wilmington, NC
  • NPI 1033412267

  NC

  Medicare reassignment
• Ubylee Healthcare Group, PLLC

  • Specialist
  • Matthews, NC
  • NPI 1265942403
  Care Compare group NPD (past)
• Ubylee Healthcare Group, PLLC

  • Family Medicine Physician
  • Rock Hill, SC
  • NPI 1922824937
  Care Compare group NPD (past)
• Ubylee Healthcare Group

  • Family Medicine Physician
  • Matthews, NC
  • NPI 1881418788
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1013099142",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3100 SPRING FOREST RD STE 130",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276162880",
            "telephone_number": "919-882-0774",
            "fax_number": "919-873-9821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3030 RANDOLPH RD",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282111368",
            "telephone_number": "704-512-4450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDEAUX",
        "first_name": "CATHERINE",
        "middle_name": "JONES",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2023-11-27",
        "certification_date": "2023-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-07164",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5209080",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAXONOMY",
            "identifier": "541913625",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI/ALLIANCE",
            "identifier": "432612",
            "state": "VA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "007601328",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SOUTHERN HEALTH",
            "identifier": "121242",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SENTARA/OPTIMA",
            "identifier": "54536",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "620043172",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "140457",
            "state": "VA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "213427",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle Delores Boose, M.D., M.P.H.
• Vernon Larry Booth, D.D.S.
• Melissa Dedmond Boothe, RN, PA-C
• Skyler Jo Booths, PHARMD
• Shannon Elizabeth Boraski
• Morgan Jean Bordeaux
• Christopher Bordelon, LCSWA
• Teresa Bordelon, CRNA
• Jennifer Boren
• Nyal Borges, MD

• All providers in Charlotte, NC
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.