Andrew B. Boldrey, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

2005022494 Issued in MO

Practice address

1012 N Main St
Sikeston, MO 63801-5044

Phone

(573) 431-0330

Fax

(573) 471-0461

NPI assigned

Jan 5, 2006

Last updated

Jan 14, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in MO

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

Merit-based Incentive Payment System (MIPS)

Final score

67.07 of 100Reported as apm

Quality

85.4

Promoting interoperability

0

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: aboldrey90261@surescripts.sfmc.net

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.

• Saint Francis Medical Center

  dba Saint Francis Medical Center Anesthesia

  • Anesthesiology Physician
  • Cape Girardeau, MO
  • NPI 1356304489
  Medicare reassignment NPD
• Saint Francis Medical Center

  dba Saint Francis Clinic Poplar Bluff

  • Rural Health Clinic/Center
  • Poplar Bluff, MO
  • NPI 1689096919
  NPD
• Saint Francis Medical Center

  dba Saint Francis Clinic Jackson

  • Clinic/Center
  • Jackson, MO
  • NPI 1992502975
  NPD
• Sikeston Imaging Center, LLC

  • Diagnostic Radiology Physician
  • Sikeston, MO
  • NPI 1730133315
  NPD
• Ferguson Medical Group Rural Health Center Inc.

  • Family Medicine Physician
  • Scott City, MO
  • NPI 1245361427
  NPD (past)

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

{
    "created_epoch": "1136419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610582400000",
    "number": "1306824735",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 801143",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641801143",
            "telephone_number": "573-331-5583",
            "fax_number": "573-331-5079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1012 N MAIN ST",
            "city": "SIKESTON",
            "state": "MO",
            "postal_code": "638015044",
            "telephone_number": "573-431-0330",
            "fax_number": "573-471-0461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLDREY",
        "first_name": "ANDREW",
        "middle_name": "B.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-05",
        "last_updated": "2021-01-14",
        "certification_date": "2021-01-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MO",
            "license": "2005022494",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MO NUMBER",
            "identifier": "199827",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTHLINK",
            "identifier": "730776",
            "state": "MO"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "207266701",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH NUMBER",
            "identifier": "430741410",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Bio-Medical Applications of Missouri, Inc. (Fresenius Medical Care Sikeston)
• Lauren Ashley Bissonnette, RN, FNP-BC
• Kevin J. Blanton, M.D.
• Leisa Y Blissett, LCSW
• Kathryn Ann Bohannon, MA,CCC-SLP
• Sandra T Bollinger, PHARMD, CGP, CDE
• Shelby Paige Bollinger, PMHNP-BC
• Valerie Lynne Bollinger, OTR
• Andrea Kaye Bone
• Donna Jean Boone-Springer, MD

• Pediatrics Physician in Sikeston, MO
• Providers in Sikeston, MO by specialty
• Pediatrics Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 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.