Kimberly Erica Boudreaux, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

333915 Issued in LA

Practice address

1514 Jefferson Hwy
New Orleans, LA 70121-2429

Phone

(504) 842-3460

NPI assigned

Jul 20, 2021

Sex

Female

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Belle Chasse Emergency Group LLCGroup PAC ID 7113140070, 95 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: kboudreaux1679878@direct.ochsner.org

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.

• Belle Chasse Emergency Group LLC

  • Emergency Medicine Physician
  • New Orleans, LA
  • NPI 1851714075
  Medicare reassignment Care Compare group
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  Medicare reassignment NPD (past)
• St Tammany Emergency Physicians Group LLC

  • Emergency Medicine Physician
  • Covington, LA
  • NPI 1891187654
  Medicare reassignment
• Ochsner Clinic LLC

  dba Diabetes Prevention Program

  • Registered Dietitian
  • Covington, LA
  • NPI 1013747039
  NPD
• Ochsner Clinic LLC

  dba Ochsner Health Center Lakeview

  • General Practice Physician
  • New Orleans, LA
  • NPI 1629232517
  NPD

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

• Ochsner Clinic Foundation

  dba Ochsner Medical Center Acute

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1811973100
  Care Compare affiliation

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

{
    "created_epoch": "1626739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672272000000",
    "number": "1356914121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-3460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "KIMBERLY",
        "middle_name": "ERICA",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-07-20",
        "last_updated": "2022-12-29",
        "certification_date": "2022-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "333915",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Bridget A Boudreaux, MD
• Charles Austin Boudreaux, D.D.S.
• David Michael Boudreaux, CRNA
• Jenesha Michelle Boudreaux
• Jessica Marie Boudreaux, D.O.
• Kristi Boudreaux, M.D.
• Lionel Boudreaux, MD
• Madison McCall Boudreaux
• Malarie Boudreaux, LCSW
• Raegen Harbour Boudreaux, PA

• Physician Assistant in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2022; 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.