Nicholas Boudreau, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

APRN11019743 Issued in FL

Practice address

104 Forest Cir
Orlando, FL 32803-6248

Phone

(954) 649-6279

NPI assigned

May 5, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesiologists of Greater Orlando IncGroup PAC ID 7416928536, 339 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Orlando Health Hospital, Orlando, FL, CCN 100006

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Anesthesiologists of Greater Orlando Inc

  • Anesthesiology Physician
  • Orange City, FL
  • NPI 1457300998

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Apollo Medical Group of Ocala LLC

  • Anesthesiology Physician
  • Ocala, FL
  • NPI 1477326908

  Single Specialty

  Medicare reassignment NPD
• Anesthesiologists of Greater Orlando Inc

  • Anesthesiology Physician
  • Clermont, FL
  • NPI 1669140745

  Nurse Anesthetist, Certified Registered

  NPD
• Anesthesiologists of Greater Orlando Inc

  • Anesthesiology Physician
  • Lake Mary, FL
  • NPI 1992524706

  Nurse Anesthetist, Certified Registered

  NPD

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

• Orlando Health, Inc.

  • General Acute Care Hospital
  • Orlando, FL
  • NPI 1184709057
  Care Compare affiliation

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

{
    "created_epoch": "1588636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657670400000",
    "number": "1609497346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 FOREST CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328036248",
            "telephone_number": "954-649-6279"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FOREST CIR",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328036248",
            "telephone_number": "954-649-6279"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAU",
        "first_name": "NICHOLAS",
        "credential": "CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-05",
        "last_updated": "2022-07-13",
        "certification_date": "2022-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "FL",
            "license": "9385003",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "11019743",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "FL",
            "license": "APRN11019743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRIVERS LICENSE",
            "identifier": "B360633910020",
            "state": "FL"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "nicholas.boudreau@mymail.barry.edu",
            "affiliation": "N",
            "endpointDescription": "nicholas.boudreau@mymail.barry.edu",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "11300 NE 2nd Ave",
            "city": "Miami Shores",
            "state": "FL",
            "country_code": "US",
            "postal_code": "331616628",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ashley Botsford, PA-C
• Donald Murrill Botta, M.D.
• Ashley Danielle Bottiglieri
• Glendalie Bou
• Holly Bouck
• Robert Boudreau
• Sonia Boudy Gonzalez
• Vanessa Bouffard
• Ishmael Bougouneau
• Brittney Bouie

• Certified Registered Nurse Anesthetist in Orlando, FL
• Providers in Orlando, FL by specialty
• Certified Registered Nurse Anesthetist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2022; 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.