Jeremy Paul Boudreaux, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

10072-123 Issued in WI

Practice address

615 N Sherman Ave Ste 24
Madison, WI 53704-4457

Phone

(608) 445-2510

Fax

(262) 293-9777

NPI assigned

Apr 1, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Merit-based Incentive Payment System (MIPS)

Final score

83.32 of 100Reported as group

Quality

87.78

Promoting interoperability

77

Improvement activities

40

Cost

75.8

Medicare enrollment (NPD)

Enrolled

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.

• Willow Counseling and Therapeutic Art Center

  • Professional Counselor
  • Madison, WI
  • NPI 1912776253

  Clinical

  NPD
• Blessing Corporate Services Inc

  • Rural Health Clinic/Center
  • Warsaw, IL
  • NPI 1720186265
  NPD (past)
• Blessing Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Quincy, IL
  • NPI 1558489021
  NPD (past)

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

{
    "created_epoch": "1554076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1790247757",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "615 N SHERMAN AVE STE 24",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044457",
            "telephone_number": "608-445-2510",
            "fax_number": "262-293-9777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "615 N SHERMAN AVE STE 24",
            "city": "MADISON",
            "state": "WI",
            "postal_code": "537044457",
            "telephone_number": "608-445-2510",
            "fax_number": "262-293-9777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "JEREMY",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-01",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "22128",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149020671",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WI",
            "license": "10072-123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vanesa LM Botsford, MD
• Emily A Bottiani
• Carin A Bouchard, PHARMD
• Randy John Bouche, RN
• Lindsey L Boucher, CAA
• Michelle Theresa Boudreaux, N.P.
• Shenikqua Bouges, MD
• Lara Skye Boughman, LPC, CSAC
• Ian Brian Bould
• Robert Kenneth Bour, M.D.

• Clinical Social Worker in Madison, WI
• Providers in Madison, WI by specialty
• Clinical Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• 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.