Individual provider Active NPI

Beau David Boudreaux, M.D.

  • Rheumatology Physician
  • Thibodaux, LA
National Provider Identifier
1972895886
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rheumatology PhysicianTaxonomy code 207RR0500X
License
MD.207047 Issued in LA
Practice address
726 N Acadia Rd Ste 3400
Thibodaux, LA 70301-5009
Phone
(985) 449-4656
NPI assigned
May 10, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Rheumatology Physician 207RR0500X MD.207047 LA Primary
Internal Medicine Physician 207R00000X MD.207047 LA

Addresses

Primary practice location

726 N Acadia Rd Ste 3400
Thibodaux, LA 70301-5009

Mailing address

PO Box 5478
Thibodaux, LA 70302-5478
Phone (985) 449-4656

Other practice location 1

1542 Tulane Ave
Mail Box T4M-2
New Orleans, LA 70112-2865
Phone (504) 568-4498

Other identifiers 1

IdentifierTypeStateIssuer
2153200MedicaidLA

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
I20160624002112 LA Practitioner - Rheumatology 1658673199 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Rheumatology
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

602 N Acadia Rd
Thibodaux, LA 70301-4823

602 N Acadia Rd
Thibodaux, LA 70301-4847

608 N Acadia Rd
Thibodaux, LA 70301-4847

726 N Acadia Rd
Suite 3400
Thibodaux, LA 70301-5011
Phone (985) 449-4656

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.55 of 100Reported as group
Quality
67.62
Promoting interoperability
100
Improvement activities
40
Cost
71.34

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Thibodaux Regional Network Development Corporation CurrentSince Aug 1, 2016 Accepting new patients
Thibodaux Regional Network Development Corporation Rheumatology CurrentSince Aug 1, 2016 Accepting new patients
Thibodaux Regional Network Development Corporation Current Accepting new patients
Thibodaux Regional Network Development Corporation Past Accepting new patients

Locations

1542 Tulane Ave
#T4M2
New Orleans, LA 70112
Phone (504) 568-2577

726 N Acadia Rd
Ste 3400
Thibodaux, LA 70301
Phone (985) 449-4656

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

Organizations & group practices 4

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.

Hospital & facility affiliations 5

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": "1304985600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1972895886",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5478",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703025478",
            "telephone_number": "985-449-4656",
            "fax_number": "985-449-2532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 N ACADIA RD STE 3400",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015009",
            "telephone_number": "985-449-4656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1542 Tulane Ave",
            "address_2": "Mail Box T4M-2",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "701122865",
            "country_code": "US",
            "telephone_number": "504-568-4498",
            "fax_number": "504-568-2127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "BEAU",
        "middle_name": "DAVID",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-05-10",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RR0500X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Rheumatology",
            "state": "LA",
            "license": "MD.207047",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.207047",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2153200",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.