Alycia Buford Boudreau, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

11002140 Issued in FL

Practice address

19605 Morden Blush Dr
Lutz, FL 33558-9087

Phone

(813) 433-3929

NPI assigned

May 29, 2019

Sex

Female

Sole proprietor

Yes

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 FL, AZ, WA, IN, TX5 enrollments

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 5

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Radiology Alliance PCGroup PAC ID 1850280470, 449 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension St Vincent Hospital Hospital, Indianapolis, IN, CCN 150084
• Ascension St Vincent Kokomo Hospital, Kokomo, IN, CCN 150010
• Ascension St Vincent Anderson Hospital, Anderson, IN, CCN 150088

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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.

• Radiology Alliance PC

  • Diagnostic Radiology Physician
  • Nashville, TN
  • NPI 1861478489

  FL

  Medicare reassignment Care Compare group NPD
• Mori Bean and Brooks Inc

  • Diagnostic Radiology Physician
  • Tampa, FL
  • NPI 1093782070

  FL

  Medicare reassignment NPD
• Radiology Physician Solutions of West Florida, LLC

  • Diagnostic Radiology Physician
  • Saint Petersburg, FL
  • NPI 1104205046

  FL

  Medicare reassignment NPD
• Multicare Health System

  • Neurological Surgery Physician
  • Tacoma, WA
  • NPI 1497766638

  WA

  Medicare reassignment NPD
• Sonoran Radiology LTD

  • Vascular & Interventional Radiology Physician
  • Mesa, AZ
  • NPI 1033745708

  AZ

  Medicare reassignment NPD
• Imaging Associates of Indiana, PC

  • Diagnostic Radiology Physician
  • Indianapolis, IN
  • NPI 1699072611

  IN

  Medicare reassignment
• Singleton Associates PA

  • Diagnostic Radiology Physician
  • Shenandoah, TX
  • NPI 1538107875

  TX

  Medicare reassignment
• Radiology Physician Solutions of West Florida, LLC

  • Diagnostic Radiology Physician
  • Plantation, FL
  • NPI 1427437367
  NPD
• Radiology Physician Solutions of West Florida, LLC

  • Diagnostic Radiology Physician
  • Inverness, FL
  • NPI 1841687811
  NPD
• Sheridan Radiology Services of Pinellas, Inc.

  • Diagnostic Radiology Physician
  • West Palm Beach, FL
  • NPI 1609211432
  NPD
• Multicare Health System

  • Family Medicine Physician
  • Covington, WA
  • NPI 1093768657
  NPD
• Multicare Health System

  • Community/Retail Pharmacy
  • Spokane, WA
  • NPI 1396594875
  NPD

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

• St. Joseph Hospital & Health Center, Inc.

  • General Acute Care Hospital
  • Kokomo, IN
  • NPI 1780625442

  Hospital

  Care Compare affiliation
• St. Vincent Anderson Regional Hospital, Inc.

  • General Acute Care Hospital
  • Anderson, IN
  • NPI 1679578850

  Hospital

  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Indianapolis, IN
  • NPI 1306898960

  Hospital

  Care Compare affiliation
• St. Vincent Hospital & Health Care Center, Inc.

  • General Acute Care Hospital
  • Avon, IN
  • NPI 1851833230

  Hospital

  Care Compare affiliation

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

{
    "created_epoch": "1559088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1580169600000",
    "number": "1649837352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19605 MORDEN BLUSH DR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335589087",
            "telephone_number": "813-433-3929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19605 MORDEN BLUSH DR",
            "city": "LUTZ",
            "state": "FL",
            "postal_code": "335589087",
            "telephone_number": "813-433-3929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAU",
        "first_name": "ALYCIA",
        "middle_name": "BUFORD",
        "credential": "FNP-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-29",
        "last_updated": "2020-01-28",
        "certification_date": "2020-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "FL",
            "license": "11002140",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gitendra Bommareddy, R.PH
• Terra Bone, LCSW
• Loicy Bonet I, BCBA-1-20-42842
• Kimberly Kathlene Booth, M.S., CCC-SLP
• Karolina Borodo, MD
• Grace Anne Boudreau, MD
• Mary Bouie
• Adina Sara Boulos, DO
• Boundless Hope
• Michael Yakov Bourtman

• All providers in Lutz, FL
• Family Nurse Practitioner in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2020; 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.