Matthew B Boudreaux, M.D.

Primary specialty

Colon & Rectal Surgery PhysicianTaxonomy code 208C00000X

License

202133 Issued in LA

Practice address

102 Drury LN
Lafayette, LA 70508-5702

Phone

(337) 233-0219

Fax

(337) 233-2418

NPI assigned

May 23, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Colorectal Surgery (Proctology)

Education

Louisiana State University School of Medicine in New Orleans, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lourdes Physician Group LLCGroup PAC ID 7214177757, 157 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Lourdes Home Health Home health agency, Lafayette, LA, CCN 197057
• Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102
• Park Place Surgical Hospital Hospital, Lafayette, LA, CCN 190255

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Lourdes Physician Group LLC

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1437405883
  Medicare reassignment Care Compare group NPD
• Lsuhn Billing LLC

  • Multi-Specialty Clinic/Center
  • Lafayette, LA
  • NPI 1992975775
  Medicare reassignment NPD
• Surgical Hospital Management System LLC

  • Surgery Physician
  • Lafayette, LA
  • NPI 1043595804
  Medicare reassignment NPD
• Lsuhn Billing LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Baton Rouge, LA
  • NPI 1306247556
  NPD
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  NPD (past)

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

• LHCG Xiii, LLC

  • Home Health Agency
  • Lafayette, LA
  • NPI 1598829129
  Care Compare affiliation
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  Care Compare affiliation
• Park Place Surgery Center, LLC

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1215996632
  Care Compare affiliation

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

{
    "created_epoch": "1179878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633046400000",
    "number": "1245440577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "337-233-0219",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 DRURY LN",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085702",
            "telephone_number": "337-233-0219",
            "fax_number": "337-233-2418"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "MATTHEW",
        "middle_name": "B",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-23",
        "last_updated": "2021-10-01",
        "certification_date": "2021-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208C00000X",
            "taxonomy_group": "",
            "desc": "Colon & Rectal Surgery",
            "state": "LA",
            "license": "202133",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen Marie Boudreaux, P.M.H.N.P.
• Kristin Lucas Boudreaux, DC, MSN, APRN
• Lindsay Harwin Boudreaux
• Lisa A Boudreaux, CPC
• Lucette Boudreaux, RN
• Mindy Boudreaux
• Scott Christopher Boudreaux, RDH
• Scott W Boudreaux, DPT
• Tina Marie Boudreaux, FNP
• Tonya Boudreaux, MD

• Colon & Rectal Surgery Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Colon & Rectal Surgery Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2021; 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.