NPIMap

Individual provider Active NPI

Jennifer Boudreau, PA-C

  • Physician Assistant
  • Flint, MI
National Provider Identifier
1922762053
Registry record updated Jan 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
1230 S Linden Rd
Flint, MI 48532-3459
Phone
(810) 410-4869
NPI assigned
Oct 25, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

1230 S Linden Rd
Flint, MI 48532-3459

Mailing address

366 Highland Ave
Rochester, MI 48307-1513

Other names 1

  • Jennifer Semaan Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241106000446 MI Practitioner - Physician Assistant 5092249664 Reassigns benefits to 14 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Behavioral Care Solutions for Adults and Seniors IncGroup PAC ID 4880918051, 71 clinicians

Practice addresses (Care Compare)

39465 W 14 Mile Rd
Novi, MI 48377-1600
Phone (877) 906-9699

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Doctors Urgent Care Southfield Past Accepting new patients

Organizations & group practices 15

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.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1635120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674086400000",
    "number": "1922762053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "366 HIGHLAND AVE",
            "city": "ROCHESTER",
            "state": "MI",
            "postal_code": "483071513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1230 S LINDEN RD",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485323459",
            "telephone_number": "810-410-4869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOUDREAU",
        "first_name": "JENNIFER",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-10-25",
        "last_updated": "2023-01-19",
        "certification_date": "2023-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "SEMAAN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Flint, MI

Sources for this page

Verify at the official NPI Registry.