Nicole H. Boudreau,MD P.C.

Primary specialty

Obstetrics PhysicianTaxonomy code 207VX0000X

License

205483 Issued in MA

Legal business name

NICOLE H. BOUDREAU,MD P.C.

Practice address

1180 Beacon St
Suite 2C
Brookline, MA 02446-3885

Phone

(617) 232-0440

Fax

(617) 232-8444

NPI assigned

Apr 12, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Nicole Hurley Boudreau, M.D.NPI 1275568305

Title

President

Phone

(617) 232-0440

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Nicole Hurley Boudreau, MD

  • Obstetrics & Gynecology Physician
  • Brookline, MA
  • NPI 1275568305
  Medicare reassignment Care Compare group NPD Authorized official
• Katherine Diane Matta, MD

  • Obstetrics & Gynecology Physician
  • Brookline, MA
  • NPI 1114129053
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197331200000",
    "number": "1396969226",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST",
            "address_2": "SUITE 2C",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463885",
            "telephone_number": "617-232-0440",
            "fax_number": "617-232-8444"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 BEACON ST",
            "address_2": "SUITE 2C",
            "city": "BROOKLINE",
            "state": "MA",
            "postal_code": "024463885",
            "telephone_number": "617-232-0440",
            "fax_number": "617-232-8444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NICOLE H. BOUDREAU,MD P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-12-11",
        "status": "A",
        "authorized_official_last_name": "BOUDREAU",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_middle_name": "HURLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "617-232-0440",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207VX0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Obstetrics",
            "state": "MA",
            "license": "205483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0108197",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David Nguyen, PH.D.
• Yen Nguyen, OD
• Nhoms, PLLC
• Nicolae Dumitriu PC
• Nicole Bodin
• Beth Ann Niernberg
• Ashok N. Nimgade, MD, MPH, MS, SM
• Nina Carroll MD, LLC
• Seiler Nishimura, LCSW
• Cheryl Beth Nissenbaum

• Obstetrics Physician in Brookline, MA
• Providers in Brookline, MA by specialty
• Obstetrics Physician in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2007; 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.

Verify at the official NPI Registry.