Individual provider Active NPI

Lara Hutchinson Boudreaux, MD

  • Gastroenterology Physician
  • Covington, LA
National Provider Identifier
1992267272
Registry record updated Mar 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
License
330834 Issued in LA
Practice address
7015 Highway 190 East Service Rd Ste 102
Covington, LA 70433-4960
Phone
(985) 893-9592
NPI assigned
Apr 4, 2019
Last updated
Mar 20, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X LA
Gastroenterology Physician 207RG0100X 330834 LA Primary

Addresses

Primary practice location

7015 Highway 190 East Service Rd Ste 102
Covington, LA 70433-4960

Mailing address

16061 Doctors Blvd Ste B
Hammond, LA 70403-1499
Phone (985) 542-1334

Other practice location 1

2003 Tulane Ave
New Orleans, LA 70112
Phone (504) 962-6110

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
I20250703000622 LA Practitioner - Internal Medicine 8325374572 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Northlake GastroenterologyGroup PAC ID 9234197419, 9 clinicians

Practice addresses (Care Compare)

16061 Doctors Blvd
Suite B
Hammond, LA 70403-1499
Phone (985) 542-1334

7015 Hwy 190 E Service Rd
Suite 102
Covington, LA 70433-4960
Phone (985) 542-1334

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy30
Upper gastrointestinal (GI) endoscopy for acid reflux59

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
330834LAMDGastroenterology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Northlake Gastroenterology CurrentSince Jul 1, 2025 Accepting new patients

Locations

7015 Highway 190 East Service Rd
Ste 103
Covington, LA 70433
Phone (985) 273-3915

7015 Highway 190 East Service Rd
Ste 102
Covington, LA 70433
Phone (985) 542-1334

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

16061 Doctors Blvd
Hammond, LA 70403
Phone (985) 542-1334

16061 Doctors Blvd
Ste B
Hammond, LA 70403
Phone (985) 542-1334

Organizations & group practices 1

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 9

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": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742428800000",
    "number": "1992267272",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16061 DOCTORS BLVD STE B",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031499",
            "telephone_number": "985-542-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7015 HIGHWAY 190 EAST SERVICE RD STE 102",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704334960",
            "telephone_number": "985-893-9592"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2003 Tulane Ave",
            "address_purpose": "LOCATION",
            "city": "New Orleans",
            "state": "LA",
            "postal_code": "70112",
            "country_code": "US",
            "telephone_number": "504-962-6110",
            "fax_number": "504-962-6111",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BOUDREAUX",
        "first_name": "LARA",
        "middle_name": "HUTCHINSON",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2025-03-20",
        "certification_date": "2025-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "LA",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "LA",
            "license": "330834",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.