Individual provider Active NPI

Bridget A Boudreaux, MD

  • Otolaryngology Physician
  • New Orleans, LA
National Provider Identifier
1336358670
Registry record updated Dec 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
License
MD.207821 Issued in LA
Practice address
120 N Jefferson Davis Pkwy
New Orleans, LA 70119-5308
Phone
(504) 821-0244
Fax
(504) 821-0255
NPI assigned
May 22, 2007
Last updated
Dec 30, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2020

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology Physician 207Y00000X TL#1725 WY
Otolaryngology Physician 207Y00000X N2413 TX
Otolaryngology Physician 207Y00000X MD.207821 LA Primary

Addresses

Primary practice location

120 N Jefferson Davis Pkwy
New Orleans, LA 70119-5308

Mailing address

120 N Jefferson Davis Pkwy
New Orleans, LA 70119-5308
Phone (504) 821-0244

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: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160215001634 LA Practitioner - Otolaryngology 5294887543 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Louisiana State University School of Medicine in New Orleans, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lousteau and Cecola AMCGroup PAC ID 6305871989, 2 clinicians

Practice addresses (Care Compare)

120 N Norman C Francis Pkwy
New Orleans, LA 70119-5308
Phone (504) 821-0244

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
TL#1725WYMDOtolaryngology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lousteau & Cecola AMC Otolaryngology CurrentSince Mar 1, 2016 Accepting new patients
Southwest Ear Nose & Throat Consultants PA Otolaryngology PastSince Nov 10, 1995 Accepting new patients

Locations

120 N Norman C Francis Pkwy
New Orleans, LA 70119

Organizations & group practices 2

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609286400000",
    "number": "1336358670",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 N JEFFERSON DAVIS PKWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701195308",
            "telephone_number": "504-821-0244",
            "fax_number": "504-821-0255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 N JEFFERSON DAVIS PKWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701195308",
            "telephone_number": "504-821-0244",
            "fax_number": "504-821-0255"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "BRIDGET",
        "middle_name": "A",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2020-12-30",
        "certification_date": "2020-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "WY",
            "license": "TL#1725",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "TX",
            "license": "N2413",
            "primary": false
        },
        {
            "code": "207Y00000X",
            "taxonomy_group": "",
            "desc": "Otolaryngology",
            "state": "LA",
            "license": "MD.207821",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.