Individual provider Active NPI

Claudette Smith-Boudreaux, O.D.

  • Optometrist
  • Church Point, LA
National Provider Identifier
1255628392
Registry record updated Dec 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1626-659T Issued in LA
Practice address
315 N Broadway St
Church Point, LA 70525-2914
Phone
(337) 684-0018
Fax
(337) 684-0715
NPI assigned
Jul 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2014

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7721T TX
Optometrist 152W00000X 1626-659T LA Primary
Optometrist 152W00000X 1626-659AT LA

Addresses

Primary practice location

315 N Broadway St
Church Point, LA 70525-2914

Mailing address

315 N Broadway St
Church Point, LA 70525-2914
Phone (337) 684-0018

Other identifiers 1

IdentifierTypeStateIssuer
2308203MedicaidLA

Medicare participation

Medicare enrollment files
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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120330000285 LA Practitioner - Optometry 7719157312 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bec Vision, LLCGroup PAC ID 4385809698, 2 clinicians

Practice addresses (Care Compare)

200 Fairway Dr
Suite a
Crowley, LA 70526-2346
Phone (337) 250-4474

Merit-based Incentive Payment System (MIPS)

Final score
86.39 of 100Reported as group
Quality
69.59
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1626-659ATLAMDOptometrist
7721TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bec Vision, LLC Optometrist CurrentSince May 19, 2012 Accepting new patients
Dr. Heidi B Doucet, P.L.L.C. Optometrist PastSince Jul 5, 2004 Accepting new patients
Jason Wonch, O.D. and Associates, a.P.C. Optometrist Past Accepting new patients

Locations

200 Fairway Dr
#A
Crowley, LA 70526
Phone (337) 250-4474

919 N Parkerson Ave
Crowley, LA 70526

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1310083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1419811200000",
    "number": "1255628392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N BROADWAY ST",
            "city": "CHURCH POINT",
            "state": "LA",
            "postal_code": "705252914",
            "telephone_number": "337-684-0018",
            "fax_number": "337-684-0715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N BROADWAY ST",
            "city": "CHURCH POINT",
            "state": "LA",
            "postal_code": "705252914",
            "telephone_number": "337-684-0018",
            "fax_number": "337-684-0715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH-BOUDREAUX",
        "first_name": "CLAUDETTE",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-07-08",
        "last_updated": "2014-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7721T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1626-659T",
            "primary": true
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1626-659AT",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2308203",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Church Point, LA

Sources for this page

Verify at the official NPI Registry.