Individual provider Active NPI

Brad Alan Boudreaux, MD

  • Emergency Medicine Physician
  • Lafayette, LA
National Provider Identifier
1811076995
Registry record updated Jan 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
201157 Issued in LA
Practice address
3619 Ambassador Caffery Pkwy
BLDG E
Lafayette, LA 70503-5132
Phone
(337) 534-4410
Fax
(337) 534-4426
NPI assigned
Nov 2, 2006
Last updated
Jan 21, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X MD.201157 LA
Emergency Medicine Physician 207P00000X 201157 LA Primary

Addresses

Primary practice location

3619 Ambassador Caffery Pkwy
BLDG E
Lafayette, LA 70503-5132

Mailing address

3619 Ambassador Caffery Pkwy
BLDG E
Lafayette, LA 70503-5132
Phone (337) 534-4410

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20070216000121 LA Practitioner - Emergency MedicinePractitioner - Family Practice 6800998105 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Clark Integrated Medical Clinics LLCGroup PAC ID 8022372598, 12 clinicians
Eunice Emergency Group LLCGroup PAC ID 3476507849, 8 clinicians
Emergency Group of St Landry LLCGroup PAC ID 0749237212, 14 clinicians

Practice addresses (Care Compare)

1135 Expressway Dr
Suite 100B
Pineville, LA 71360-6666
Phone (318) 793-7910

3501 Hwy 190
Eunice, LA 70535-5129
Phone (337) 580-7500

800 E Main St
Ville Platte, LA 70586-4618
Phone (337) 363-5684

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
95.49 of 100Reported as group
Quality
91.23
Improvement activities
40
Cost
70.6

Merit-based Incentive Payment System (MIPS)

Final score
91.08 of 100Reported as group
Quality
84.35
Improvement activities
40
Cost
72.56

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
201157LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Eunice Emergency Group LLC Emergency Medicine CurrentSince Sep 30, 2017 Accepting new patients
Clark Integrated Medical Clinics LLC General Practice CurrentSince Apr 2, 2018 Accepting new patients
Emergency Group of St Landry LLC Emergency Medicine CurrentSince Dec 2, 2019 Accepting new patients
Opelousas Emergency Group LLC Emergency Medicine CurrentSince Mar 8, 2014 Accepting new patients
Main Street Emergency Group LLC Emergency Medicine CurrentSince Dec 15, 2014 Accepting new patients
Louisiana Physical Therapy Centers of Pineville LLC PastSince Apr 2, 2018 Accepting new patients
Louisiana Brain Injury Specialists, LLC PastSince Sep 28, 2025 Accepting new patients

Locations

3501 Highway 190
Eunice, LA 70535
Phone (337) 580-7500

401 E Verot School Rd
Lafayette, LA 70508
Phone (337) 232-3353

1833 E Main St
New Iberia, LA 70560
Phone (337) 367-7463

2315 E Main St
New Iberia, LA 70560
Phone (337) 364-0441

539 E Prudhomme St
Opelousas, LA 70570
Phone (337) 943-7128

1135 Expressway Dr
Ste 100B
Pineville, LA 71360
Phone (318) 487-6525

800 E Main St
Ville Platte, LA 70586
Phone (337) 363-5684

Organizations & group practices 7

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737417600000",
    "number": "1811076995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3619 AMBASSADOR CAFFERY PKWY",
            "address_2": "BLDG E",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705035132",
            "telephone_number": "337-534-4410",
            "fax_number": "337-534-4426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3619 AMBASSADOR CAFFERY PKWY",
            "address_2": "BLDG E",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705035132",
            "telephone_number": "337-534-4410",
            "fax_number": "337-534-4426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "BRAD",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-02",
        "last_updated": "2025-01-21",
        "certification_date": "2025-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "MD.201157",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "201157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.