Ann Marie Boudreau, PT DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

9803 Issued in AZ

Practice address

24871 S Ellsworth Rd Ste 110
Queen Creek, AZ 85142-1575

Phone

(480) 769-9753

Fax

(480) 769-9754

NPI assigned

Aug 23, 2010

Last updated

May 7, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 1

• Ann Marie Bradosky Former name

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Next Level Physical Therapy and Performance IncGroup PAC ID 3375845522, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Next Level Physical Therapy and Performance Inc.

  • Physical Therapist
  • Scottsdale, AZ
  • NPI 1881061257
  Medicare reassignment Care Compare group NPD
• 360 Physical Therapy, LLC

  • Specialist
  • Scottsdale, AZ
  • NPI 1932430949
  Medicare reassignment NPD
• 360 Physical Therapy LLC

  • Specialist
  • Mesa, AZ
  • NPI 1073646980
  NPD
• 360 Physical Therapy LLC

  dba 360 Physical Therapy

  • Physical Therapist
  • Queen Creek, AZ
  • NPI 1689115164
  NPD
• Avicenna Integrative Medicine PLC

  • Internal Medicine Physician
  • Phoenix, AZ
  • NPI 1568944148
  NPD (past)
• Buffalo Rehab Group Physical Therapy and Occupational Therapy PC

  • Physical Therapist
  • West Seneca, NY
  • NPI 1548290943
  NPD (past)

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

{
    "created_epoch": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1746576000000",
    "number": "1912213414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 TUMWATER BLVD SE STE 113",
            "city": "TUMWATER",
            "state": "WA",
            "postal_code": "985016422",
            "telephone_number": "360-528-3300",
            "fax_number": "360-528-8162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24871 S ELLSWORTH RD STE 110",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "851421575",
            "telephone_number": "480-769-9753",
            "fax_number": "480-769-9754"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAU",
        "first_name": "ANN MARIE",
        "credential": "PT DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2025-05-07",
        "certification_date": "2025-05-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "033048",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AZ",
            "license": "9803",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "736900",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ANN MARIE",
            "last_name": "BRADOSKY",
            "credential": "PT DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Leslie Boag, MSW, LCSW
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• Botanical Protection LLC (Botanical Wellness Center)
• Amy Bowes
• Robert Charles Bowman, M.D.
• Makenna Marie Box
• Jena Patrice Boynton, WHNP-BC
• Carol S Bradford, NP-C

• Physical Therapist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Physical Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.