Active NPI
Roy P. Boucvalt, MD
- Anesthesiology Physician
- Kenner, LA
National Provider Identifier
1740237338
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 011519
- Practice address
- 180 W Esplanade Ave
Anesthesia Dept.
Kenner, LA 70065-2467 - Phone
- (504) 464-8054
- NPI assigned
- May 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 011519 | LA | Primary |
Addresses
Primary practice location
180 W Esplanade Ave
Anesthesia Dept.
Kenner, LA 70065-2467
Mailing address
1025 Saint Louis St
New Orleans, LA 70112-3419
Phone (504) 523-1054
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1196061 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 011519 | LA | MD | Anesthesiology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224460800000",
"number": "1740237338",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1025 SAINT LOUIS ST",
"city": "NEW ORLEANS",
"state": "LA",
"postal_code": "701123419",
"telephone_number": "504-523-1054"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "180 W ESPLANADE AVE",
"address_2": "ANESTHESIA DEPT.",
"city": "KENNER",
"state": "LA",
"postal_code": "700652467",
"telephone_number": "504-464-8054"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOUCVALT",
"first_name": "ROY",
"middle_name": "P.",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-28",
"last_updated": "2008-10-20",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "LA",
"license": "011519",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1196061",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Kenner, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.