Individual provider Active NPI

Eric Jarsin Boudreaux, O.D.

  • Optometrist
  • Church Point, LA
National Provider Identifier
1598078628
Registry record updated May 21, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1604-637T Issued in LA
Practice address
315 N Broadway St
Church Point, LA 70525-2914
Phone
(337) 684-0018
Fax
(337) 684-0715
NPI assigned
Jul 18, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 21, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 7544T TX
Optometrist 152W00000X 1604-637T LA Primary

Addresses

Primary practice location

315 N Broadway St
Church Point, LA 70525-2914

Mailing address

315 N Broadway St
Church Point, LA 70525-2914
Phone (337) 684-0018

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120711000265 LA Practitioner - Optometry 4183806649 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Houston - College of Optometry, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bec Vision, LLCGroup PAC ID 4385809698, 2 clinicians

Practice addresses (Care Compare)

200 Fairway Dr
Suite a
Crowley, LA 70526-2346
Phone (337) 250-4474

Merit-based Incentive Payment System (MIPS)

Final score
93.94 of 100Reported as individual
Quality
81.54
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery21

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1604-637TLAMDOptometrist
7544TTXMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Bec Vision, LLC Optometrist CurrentSince Jul 1, 2012 Accepting new patients
Dr. Heidi B Doucet, P.L.L.C. Optometrist PastSince Jul 5, 2004 Accepting new patients

Locations

200 Fairway Dr
#A
Crowley, LA 70526
Phone (337) 250-4474

919 N Parkerson Ave
Crowley, LA 70526

Interoperability endpoints

  • Direct secure messaging: eric.boudreauxod@direct.revolutionehr.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1279411200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1598078628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 N BROADWAY ST",
            "city": "CHURCH POINT",
            "state": "LA",
            "postal_code": "705252914",
            "telephone_number": "337-684-0018",
            "fax_number": "337-684-0715"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 N BROADWAY ST",
            "city": "CHURCH POINT",
            "state": "LA",
            "postal_code": "705252914",
            "telephone_number": "337-684-0018",
            "fax_number": "337-684-0715"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "ERIC",
        "middle_name": "JARSIN",
        "name_prefix": "Dr.",
        "credential": "O.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-07-18",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "TX",
            "license": "7544T",
            "primary": false
        },
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "LA",
            "license": "1604-637T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Church Point, LA

Sources for this page

Verify at the official NPI Registry.