Individual provider Active NPI

Ronald L. Boudreaux, MD

  • Gastroenterology Physician
  • Baton Rouge, LA
National Provider Identifier
1407883036
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
078620 Issued in LA
Practice address
7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone
(225) 769-4044
NPI assigned
Jun 27, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X 078620 LA Primary

Addresses

Primary practice location

7373 Perkins Rd
Baton Rouge, LA 70808-4326

Mailing address

7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone (225) 769-4044

Other identifiers 1

IdentifierTypeStateIssuer
1927481MedicaidLA

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
I20100504000045 LA Practitioner - GastroenterologyPractitioner - Internal Medicine 2769432327 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Gastroenterology
Education
Louisiana State University School of Medicine in New Orleans, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

7373 Perkins Rd
Baton Rouge, LA 70808-4326
Phone (225) 246-9790

7373 Perkins Rd
Baton Rouge, LA 70808-4373

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy79
Upper gastrointestinal (GI) endoscopy for acid reflux38

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
078620LAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Clinic, a Medical Corporation CurrentSince Jul 1, 1992 Accepting new patients
Baton Rouge Clinic, a Medical Corporation Gastroenterology CurrentSince Jul 1, 1992 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients

Locations

7373 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-9790

Interoperability endpoints

  • Direct secure messaging: rboudreaux4045@direct.casso.us.com

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 and National Provider Directory roles.

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": "1151366400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1407883036",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7373 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084326",
            "telephone_number": "225-769-4044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7373 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084326",
            "telephone_number": "225-769-4044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "RONALD",
        "middle_name": "L.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-27",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "LA",
            "license": "078620",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1927481",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.