Active NPI
Jacob Boudreau, CRNA
- Certified Registered Nurse Anesthetist
- Asheville, NC
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- 5427
- Practice address
- 509 Biltmore Ave
Asheville, NC 28801-4601 - Phone
- (828) 213-1111
- NPI assigned
- May 26, 2016
- Last updated
- Feb 12, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | C-APN.0004324-C-CRNA | CO | |
| Certified Registered Nurse Anesthetist | 367500000X | 5427 | NC | Primary |
Addresses
Primary practice location
509 Biltmore Ave
Asheville, NC 28801-4601
Mailing address
509 Biltmore Ave
Asheville, NC 28801-4601
Phone (828) 213-1111
Other practice location 1
11600 W 2nd Pl
Lakewood, CO 80228-1527
Phone (720) 321-1010
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Certified Registered Nurse Anesthetist (Crna)
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
11600 W 2ND PL
St. Anthony Hospital
Lakewood, CO 80228-1527
Phone (720) 321-0000
Hospital & facility affiliations
Merit-based Incentive Payment System (MIPS)
- Final score
- 84.8 of 100
- Quality
- 85
- Improvement activities
- 40
- Cost
- 76.83
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Certified Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5427 | NC | MD | Massage Therapist |
| C-APN.0004324-C-CRNA | CO | MD | Certified Registered Nurse Anesthetist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Poudre Valley Medical Group, LLC | Anesthesiology | Current | Accepting new patients |
| Poudre Valley Medical Group, LLC | Current | Accepting new patients | |
| US Anesthesia Partners of Colorado Inc. | Anesthesiology | Current | Accepting new patients |
Locations
8000 E Maplewood Ave
Ste 120
Greenwood Village, CO 80111
11600 W 2nd Pl
Lakewood, CO 80228
Phone (720) 321-1010
10101 Ridgegate Pkwy
Lone Tree, CO 80124
Phone (720) 225-1000
400 W 16th St
Pueblo, CO 81003
Phone (719) 584-4000
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Anesthesiology Physician
- Greenwood Village, CO
- NPI 1922365782
-
dba UCHealth Medical Group
- General Practice Physician
- Loveland, CO
- NPI 1225356868
Anesthesiology
-
dba UCHealth Medical Group
- General Practice Physician
- Loveland, CO
- NPI 1366763260
Hospital & facility affiliations 8
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba HCA HealthONE Sky Ridge Hospital
- General Acute Care Hospital
- Lone Tree, CO
- NPI 1659325629
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1184263527
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1376183145
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1417596834
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1427689652
-
dba Parkview Medical Center
- General Acute Care Hospital
- Pueblo, CO
- NPI 1104881507
-
- General Acute Care Hospital
- Pueblo, CO
- NPI 1134751712
-
dba Parkview Pueblo West
- General Acute Care Hospital
- Pueblo West, CO
- NPI 1821720681
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1464220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739318400000",
"number": "1316395759",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "509 BILTMORE AVE",
"city": "ASHEVILLE",
"state": "NC",
"postal_code": "288014601",
"telephone_number": "828-213-1111"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "509 BILTMORE AVE",
"city": "ASHEVILLE",
"state": "NC",
"postal_code": "288014601",
"telephone_number": "828-213-1111"
}
],
"practiceLocations": [
{
"address_1": "11600 W 2nd Pl",
"address_purpose": "LOCATION",
"city": "Lakewood",
"state": "CO",
"postal_code": "802281527",
"country_code": "US",
"telephone_number": "720-321-1010",
"fax_number": "720-321-1001",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOUDREAU",
"first_name": "JACOB",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-05-26",
"last_updated": "2025-02-12",
"certification_date": "2025-02-12",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "CO",
"license": "C-APN.0004324-C-CRNA",
"primary": false
},
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "NC",
"license": "5427",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Asheville, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2025; 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.