AMANDA DENDIS BOUDREAUX MD
NPI 1548900475
Student in an Organized Health Care Education/Training Program in St Petersburg, FL

Q: What is Amanda Boudreaux's NPI number?

The NPI number for Amanda Boudreaux is 1548900475. It was assigned to this individual provider in the NPPES registry on March 30, 2022. The provider is also known as Amanda Christine Dendis.

Q: What is Amanda Boudreaux's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Q: When was this NPI record last updated?

The NPPES record for Amanda Boudreaux was last updated on April 5, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since March 30, 2022PECOS Enrolled

700 6TH ST S, ST PETERSBURG, FL 33701(727) 893-6198(727) 893-6978 Get Directions Write a Review

NPPES record last updated: April 5, 2022. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Amanda Dendis Boudreaux Md NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AMANDA DENDIS BOUDREAUX MD (NPI 1548900475) is an individual student in an organized health care education/training program in St Petersburg, Florida and active in the NPI registry since March 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1548900475

Entity TypeIndividualFemale

Primary Taxonomy390200000X

Provider Legal NameAMANDA DENDIS BOUDREAUXCredential: MD

Location Address700 6TH ST SSt Petersburg, FL 33701-4815

Mailing Address700 6th St SSt Petersburg, FL 33701-4815 · (727) 893-6198 · Fax (727) 893-6978

Phone(727) 893-6198

Fax(727) 893-6978

Sole ProprietorNo

Enumeration DateMarch 30, 2022

Last NPPES UpdateApril 5, 2022

NPPES CertifiedApril 5, 2022

✔ NPI 1548900475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care

Taxonomy Code390200000X

Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

700 6TH ST S, St Petersburg, FL 33701

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Other Names 1

Former Name (1)Amanda Christine Dendis

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Amanda Dendis Boudreaux Md is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DR. DAVID D. DESPER JR. M.D.

Obstetrics & Gynecology