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LEIANE MOORE BOUDREAU ARNP
NPI 1588833958
Nurse Practitioner in Saint Augustine, FL

Active since February 29, 2008PECOS Enrolled
1301 PLANTATION ISLAND DR S, SUITE 106A, SAINT AUGUSTINE, FL 32080(904) 460-9191(904) 471-4859 Get Directions Write a Review

NPPES record last updated: January 5, 2015. Verified against the NPPES registry weekly; last sync: October 18, 2026.

About Leiane Moore Boudreau Arnp NPPES

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

LEIANE MOORE BOUDREAU ARNP (NPI 1588833958) is an individual nurse practitioner in Saint Augustine, Florida, licensed in Florida (ARNP2514302) and active in the NPI registry since February 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1588833958
Entity TypeIndividualFemale
Primary Taxonomy363L00000X
Provider Legal NameLEIANE MOORE BOUDREAUCredential: ARNP
Location Address1301 PLANTATION ISLAND DR S, SUITE 106ASaint Augustine, FL 32080-3108
Mailing Address1301 Plantation Island Dr S, Suite 106aSaint Augustine, FL 32080-3108 · (904) 460-9191 · Fax (904) 471-4859
Phone(904) 460-9191
Fax(904) 471-4859
Sole ProprietorNo
Enumeration DateFebruary 29, 2008
Last NPPES UpdateJanuary 5, 2015
✔ NPI 1588833958 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363L00000X
License✔ Licensed in FL · ARNP2514302
Definition
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
1301 PLANTATION ISLAND DR S, Saint Augustine, FL 32080
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Other Names 1

Professional Name (2)Leiane C Moore Arnp

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Leiane Moore Boudreau Arnp 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.

Medicare Billing Reassignment

Medicare enrollment records show Leiane Boudreau reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Paragon Emergency Services LLC
128 mi
Emergency Medicine
200 AVENUE F NE
Winter Haven, FL 33881
  • Reassigned Medicare billing, Florida enrollment
  • 1,065 clinicians in this Medicare group
NPI 1912101650 (863) 293-1121

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 32080 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$87.62 typical visit price
range $56.00 – $171.84
Typical copayment $21.90 (range $14.00 – $42.96)
Most-billed visit code 99203
Established Patient
$99.16 typical visit price
range $17.57 – $139.16
Typical copayment $24.79 (range $4.39 – $34.79)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Referred Medical Equipment & Supplies CMS DME claims

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Powered pressure-reducing air mattress E0277
DME-Hospital Beds · category DB000N
1 supplier11 claims11 services$277.23 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

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. MELCHOR G BARROS MD
Family Medicine
1301 PLANTATION ISLAND DR S, 102-B
ST AUGUSTINE, FL 32080
St. Johns County (904) 471-2593
RYAN J PEREIRA DPM
Podiatrist (Foot & Ankle Surgery)
1301 PLANTATION ISLAND DR S, STE 203
ST AUGUSTINE, FL 32080
St. Johns County (904) 461-0821
DR. MIGUEL A MAS JR. MD
Pediatrics
1301 PLANTATION ISLAND DR S, SUITE 404
ST AUGUSTINE, FL 32080
St. Johns County (904) 461-1560
MICHAEL HINES
Hearing Instrument Specialist
1301 PLANTATION ISLAND DR S, SUITE 401B
ST AUGUSTINE, FL 32080
St. Johns County (904) 264-0075
DR. FRANCISCO DIAZ JR. D.M.D.
Dentist (General Practice)
1301 PLANTATION ISLAND DR S, SUITE 104 B
ST AUGUSTINE, FL 32080
St. Johns County (904) 461-5566
MEDICAL PROFESSIONALS OF NORTH FLORIDA
Internal Medicine
1301 PLANTATION ISLAND DR S, SUITE 106A
SAINT AUGUSTINE, FL 32080
St. Johns County (904) 460-9191
SCOTT FORREST CORNEAL DO
Physical Medicine & Rehabilitation (Pain Medicine)
1301 PLANTATION ISLAND DR S, SUITE 402A
ST AUGUSTINE, FL 32080
St. Johns County (904) 471-4744
DR. CARMEN C VIVERO M.D.
Internal Medicine (Addiction Medicine)
1301 PLANTATION ISLAND DR S, SUITE 402-B
ST AUGUSTINE, FL 32080
St. Johns County (904) 460-0707

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Leiane Boudreau's NPI number?

The NPI number for Leiane Boudreau is 1588833958. It was assigned to this individual provider in the NPPES registry on February 29, 2008. The provider is also known as Leiane C Moore Arnp.

Where is Leiane Boudreau located?

Leiane Boudreau practices at 1301 Plantation Island Dr S Suite 106A, Saint Augustine, FL 32080. The listed phone number is (904) 460-9191.

What is Leiane Boudreau's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Leiane Boudreau enrolled in Medicare?

Yes. Leiane Boudreau is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Leiane Boudreau's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Leiane Boudreau reassigns Medicare benefits to Paragon Emergency Services LLC (Winter Haven, FL). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Leiane Boudreau's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Leiane Boudreau was last updated on January 5, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.