Stephen Anthony Boudreaux, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

014239 Issued in LA

Practice address

520 N Lewis St Ste 203
New Iberia, LA 70563-2094

Phone

(337) 364-3444

Fax

(337) 364-3224

NPI assigned

Jul 21, 2006

Last updated

Mar 14, 2019By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-usa.unify.chbase.com/org/ibermed-05842f36

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.

• Iberia Medical Center Physician Practice Network

  • Family Medicine Physician
  • New Iberia, LA
  • NPI 1518265297
  Medicare reassignment NPD
• Stephen a Boudreaux MD

  • Family Medicine Physician
  • Jeanerette, LA
  • NPI 1427247071
  NPD (past) Authorized official
• Hospital Service District No. 1 of Iberia Parish

  dba Iberia Medical Center

  • General Acute Care Hospital
  • New Iberia, LA
  • NPI 1780690180
  NPD

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

{
    "created_epoch": "1153440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1552521600000",
    "number": "1649291238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 N LEWIS ST STE 203",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632094",
            "telephone_number": "337-364-3444",
            "fax_number": "337-364-3224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 N LEWIS ST STE 203",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632094",
            "telephone_number": "337-364-3444",
            "fax_number": "337-364-3224"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "STEPHEN",
        "middle_name": "ANTHONY",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-21",
        "last_updated": "2019-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "014239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1906336",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Aaron Bordelon, CRNA
• Thomas Aaron Borland, MD
• Donald Paul Boudreaux Jr., DDS
• Jaime M. Boudreaux, M.D.
• Lynzie Elizabeth Boudreaux, MD
• Johanna Bourgeois, R.N.
• Natalie Bourque
• Reginald Boutte
• Carol Bradley
• Matthew Benjamin Brady, DDS

• Family Medicine Physician in New Iberia, LA
• Providers in New Iberia, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.