JOHN ANTHONY BOUDREAU MD NPI 1053338640

NPI Information

  • NPI: 1053338640
  • Provider Name: JOHN ANTHONY BOUDREAU, MD
  • Classification: Orthopaedic Surgery - 207X00000X
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 1201 S GRAND BLVD
    SAINT LOUIS, MO
    ZIP 63104
  • Phone: (314) 257-8000

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NPI Details

John Anthony Boudreau, MD is an orthopaedic surgery in Saint Louis, MO with 25 years of experience. The provider is an orthopaedic surgeon is trained in the preservation, investigation and restoration of the form and function of the extremities, spine and associated structures by medical, surgical and physical means. An orthopaedic surgeon is involved with the care of patients whose musculoskeletal problems include congenital deformities, trauma, infections, tumors, metabolic disturbances of the musculoskeletal system, deformities, injuries and degenerative diseases of the spine, hands, feet, knee, hip, shoulder and elbow in children and adults. An orthopaedic surgeon is also concerned with primary and secondary muscular problems and the effects of central or peripheral nervous system lesions of the musculoskeletal system. John Anthony Boudreau, MD NPI is 1053338640. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: WAYNE STATE UNIVERSITY SCHOOL OF MEDICINE
Graduation Year:2000

The provider's business location address is:

1201 S GRAND BLVD
SAINT LOUIS, MO
ZIP 63104-016
Phone: (314) 257-8000
Fax: (314) 268-5121

The NPI 1053338640 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Established patient office or other outpatient visit, 20-29 minutes (HCPCS:99213)
  • Initial hospital inpatient care per day, typically 30 minutes (HCPCS:99221)

The enumeration date for this NPI number is 7/17/2006 and was last updated on 5/3/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207X00000XOrthopaedic SurgeryD0063481MARYLANDYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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