Amy Boudreau, APRN
Individual provider Active NPI Nurse Practitioner · Trumbull, CT
NPI 1194729913 · NPPES record last updated Apr 1, 2015
Key facts
- NPI
- 1194729913
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- 002411 (CT)
- Practice address
- 115 Technology Dr
Suite 300
Trumbull, CT 06611-6337 - Phone
- (203) 445-7093
- Fax
- (203) 445-7094
- NPI assigned
- Jun 9, 2005
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 14
Hospital & facility affiliations 6
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
- Yale University
Practice addresses (Care Compare)
111 Goose LN
Guilford, CT 06437-5101
Phone (203) 747-7300
1450 Chapel St B
New Haven, CT 06511-4405
Phone 20386754204405
800 Howard Ave
New Haven, CT 06519-1369
Phone (203) 785-2140
Hospital & facility affiliations
- Yale-New Haven Hospital
- Bridgeport Hospital
- Lawrence & Memorial Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 87.36 of 100
- Quality
- 77.36
- Promoting interoperability
- 100
- Improvement activities
- 40
- Cost
- 74.27
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in CT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040812000411 | CT | Practitioner - Nurse Practitioner | 9133191836 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 002411 | CT | MD | Pediatric Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Yale University | Current |
Accepting new patients | |
| Yale University | Current |
Accepting new patients | |
| Cardiology Associates of Central Connecticut,LLC | Past | Accepting new patients | |
| Gaylord Hospital, Inc. | Past |
Accepting new patients |
Locations
800 Howard Ave
New Haven, CT 06519
Phone (203) 785-2140
50 Gaylord Farm Rd
Wallingford, CT 06492
Phone (203) 679-3553
Interoperability endpoints
- aboudreau188803@direct.ynhh.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 002411 | CT | Yes |
Addresses
Primary practice location
115 Technology Dr
Suite 300
Trumbull, CT 06611-6337
Mailing address
115 Technology Dr
Suite 300
Trumbull, CT 06611-6337
Phone (203) 445-7093
Other providers in Trumbull, CT
- Poornima Bond
- David Bonheim
- Bryanna Bonner
- Peter Stuart Boone
- Marivic Dayrit Botta
- Hanaa Dabaa Boutros
- Laura Bracale
- David M. Brady
- Natalia Brakoniecki
- Justin Elijah Brantley
All providers in Trumbull, CT · Nurse Practitioner in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 1, 2015. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.