Individual provider Active NPI

Arielle Boudreaux, AA

  • Anesthesiologist Assistant
  • Saint Louis, MO
National Provider Identifier
1184398893
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiologist AssistantTaxonomy code 367H00000X
License
AA963 Issued in FL
Practice address
615 S New Ballas Rd
Saint Louis, MO 63141-8221
Phone
(636) 386-9224
Fax
(636) 386-7679
NPI assigned
Aug 5, 2021
Last updated
Dec 18, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiologist Assistant 367H00000X MO
Anesthesiologist Assistant 367H00000X AA963 FL Primary

Addresses

Primary practice location

615 S New Ballas Rd
Saint Louis, MO 63141-8221

Mailing address

339 Consort Dr
Ballwin, MO 63011-4439
Phone (636) 386-9224

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO, FL, NM3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20211001001202 MO Practitioner - Anesthesiology Assistant 0941608152 Reassigns benefits to 1 organization
I20241204002232 FL Practitioner - Anesthesiology Assistant 0941608152 Reassigns benefits to 1 organization
I20250306000981 NM Practitioner - Anesthesiology Assistant 0941608152 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology Assistant
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Vincent HospitalGroup PAC ID 6608775135, 335 clinicians

Practice addresses (Care Compare)

2990 Rodeo Park Dr E
Santa Fe, NM 87505-6302
Phone (505) 913-8900

433 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 988-1232

445 Saint Michaels Dr
Santa Fe, NM 87505-7601
Phone (505) 913-8900

455 Saint Michaels Dr
Santa Fe, NM 87505-7601

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Associate of Arts

State licenses

LicenseStateTypeSpecialty
AA963FLMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
St. Vincent Hospital CurrentSince Feb 24, 2025 Accepting new patients
Western Anesthesiology Associates, Inc. CurrentSince Oct 4, 2021 Accepting new patients
Ams National LLC CurrentSince Oct 15, 2024 Accepting new patients
St Vincent Hospital Current Accepting new patients
St Vincent Hospital CurrentSince Feb 24, 2025 Accepting new patients

Locations

6002 Berryhill Rd
Milton, FL 32570
Phone (850) 474-8688

5013 N Armenia Ave
Tampa, FL 33603
Phone (813) 875-0562

339 Consort Dr
Ballwin, MO 63011
Phone (636) 386-7222

615 S New Ballas Rd
Saint Louis, MO 63141
Phone (314) 251-4687

455 Saint Michaels Dr
Santa Fe, NM 87505
Phone (505) 913-3361

Organizations & group practices 6

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 1

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": "1628121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1184398893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "339 CONSORT DR",
            "city": "BALLWIN",
            "state": "MO",
            "postal_code": "630114439",
            "telephone_number": "636-386-9224",
            "fax_number": "636-200-4243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 S NEW BALLAS RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631418221",
            "telephone_number": "636-386-9224",
            "fax_number": "636-386-7679"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "ARIELLE",
        "name_prefix": "Ms.",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-05",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "MO",
            "license": null,
            "primary": false
        },
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "FL",
            "license": "AA963",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Louis, MO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.