NPIMap

Individual provider Active NPI

Chester Gregory Boudreaux, MD

  • General Practice Physician
  • Thibodaux, LA
National Provider Identifier
1073502472
Registry record updated Apr 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
022212 Issued in LA
Practice address
142 Rue Marguerite
Thibodaux, LA 70301-6738
Phone
(985) 446-2131
Fax
(985) 447-3383
NPI assigned
Oct 18, 2005
Last updated
Apr 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.022212 LA
General Practice Physician 208D00000X 022212 LA Primary

Addresses

Primary practice location

142 Rue Marguerite
Thibodaux, LA 70301-6738

Mailing address

142 Rue Marguerite
Thibodaux, LA 70301-6738
Phone (985) 446-2131

Other identifiers 1

IdentifierTypeStateIssuer
1493783MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071207000486 LA Practitioner - Internal Medicine 3476642802 Reassigns benefits to 1 organization
Practice locations: Thibodaux, LA

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chester G Boudreaux MD IncGroup PAC ID 2365725462, 2 clinicians

Practice addresses (Care Compare)

142 -B Rue Marguerite
Thibodaux, LA 70301-6708

142 Rue Marguerite
Thibodaux, LA 70301-6708
Phone (985) 448-2131

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10
Removal or shaving of skin growth1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.022212LAMDInternal Medicine Physician
022212LAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Thibodaux Internal Medicine Associates,Inc. Internal Medicine CurrentSince Jan 8, 2020 Accepting new patients
Lafourche Home for the Aged & Infirm, Inc. Past Accepting new patients
James T Soignet M D L L C Internal Medicine PastSince Oct 19, 2020 Accepting new patients

Locations

142 Rue Marguerite
Thibodaux, LA 70301
Phone (985) 446-2131

142 Rue Marguerite
#G
Thibodaux, LA 70301
Phone (985) 446-2131

142 Rue Marguerite
Ste B
Thibodaux, LA 70301
Phone (985) 446-2131

Interoperability endpoints

  • Direct secure messaging: chesterboudreaux@rimallc.allscriptsdirect.net

Organizations & group practices 4

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

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1129593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743638400000",
    "number": "1073502472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "142 RUE MARGUERITE",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703016738",
            "telephone_number": "985-446-2131",
            "fax_number": "985-447-3383"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "142 RUE MARGUERITE",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703016738",
            "telephone_number": "985-446-2131",
            "fax_number": "985-447-3383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "CHESTER",
        "middle_name": "GREGORY",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-10-18",
        "last_updated": "2025-04-03",
        "certification_date": "2025-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.022212",
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "022212",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1493783",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.