Kristina Bordeaux, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

Practice address

1211 Coolidge Blvd # 303
Lafayette, LA 70503-2636

Phone

(337) 232-6697

NPI assigned

Aug 18, 2022

Last updated

Aug 18, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

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

Larry K. Broadwell, M.D., a Medical CorporationGroup PAC ID 7113984402, 10 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

100

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/BAJHBA

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.

• Rheumatology and Osteoporosis Specialists, AMC

  • Rheumatology Physician
  • Shreveport, LA
  • NPI 1689766271
  Medicare reassignment Care Compare group
• Louisiana Gastroenterology Associates LLC

  • Gastroenterology Physician
  • Lafayette, LA
  • NPI 1366195091
  Medicare reassignment
• Gastroenterology Clinic of Acadiana LLC

  • Gastroenterology Physician
  • Lafayette, LA
  • NPI 1841363512
  NPD
• Rheumatology and Osteoporosis Specialists, AMC

  dba Rheumatology and Osteoporosis Specialists Pharmacy

  • Pharmacy
  • Shreveport, LA
  • NPI 1477343713
  NPD (past)

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

{
    "created_epoch": "1660780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660780800000",
    "number": "1619695384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 223",
            "city": "MILTON",
            "state": "LA",
            "postal_code": "705580223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 COOLIDGE BLVD # 303",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032636",
            "telephone_number": "337-232-6697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDEAUX",
        "first_name": "KRISTINA",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-18",
        "last_updated": "2022-08-18",
        "certification_date": "2022-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chris David Bonvillain
• David T Booher, MD
• Michael Wilfred Prosper Boos Jr., MD
• Patrick Booth, MD
• Traci Lynn Boothe, APRN, FNP-BC, ONC
• Amy Brooke Bordelon, PMHNP
• Haley Nicole Bordelon, LMT, CERTIFIED ROLFE
• Jacob Sebastien Bordelon
• Jade Bordelon, MCD, CCC-SLP
• Lauren Ashley Bordelon, LPC

• Physician Assistant in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 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.