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MARK RICARD BOUDREAU JR. DO
NPI 1659834323
Pediatrics in Rome, GA

Active since April 10, 2019PECOS Enrolled
304 SHORTER AVE NW STE 105, ROME, GA 30165(706) 236-4880 Get Directions Write a Review

NPPES record last updated: May 26, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: May 26, 2023, Mar 7, 2023, Nov 17, 2022 and 3 more (6 updates tracked since 2019).

About Mark Ricard Boudreau Jr. Do NPPES

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

MARK RICARD BOUDREAU JR. DO (NPI 1659834323) is an individual pediatrics provider in Rome, Georgia, licensed in Georgia (11273) and active in the NPI registry since April 2019. He is enrolled in Medicare PECOS and maintains a secondary practice location in Cedartown.

NPPES Registry Identity

NPI1659834323
Entity TypeIndividualMale
Primary Taxonomy208000000X
Provider Legal NameMARK RICARD BOUDREAU JR.Credential: DO
Location Address304 SHORTER AVE NW STE 105Rome, GA 30165-4256
Mailing Address420 E 2nd Ave Ste 103Rome, GA 30161-3210 · (706) 509-3000
Phone(706) 236-4880
Sole ProprietorNo
Enumeration DateApril 10, 2019
Last NPPES UpdateMay 26, 20236 updates tracked since enumeration
NPPES CertifiedMay 26, 2023
✔ NPI 1659834323 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatricsAllopathic & Osteopathic Physicians
Taxonomy Code208000000X
License✔ Licensed in GA · 11273
Definition
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.
304 SHORTER AVE NW STE 105, Rome, GA 30165
Open in Google Maps ↗

Secondary Practice Location 1

Location 12370 Rockmart Hwy Ste 100Cedartown, GA 30125-6029 · Phone (770) 748-7818

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc., Ambetter from Absolute Total Care, Ambetter Health and more.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mark Ricard Boudreau Jr. Do 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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30165 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
$83.23 typical visit price
range $53.31 – $164.04
Typical copayment $20.80 (range $13.32 – $41.01)
Most-billed visit code 99203
Established Patient
$94.84 typical visit price
range $16.68 – $133.24
Typical copayment $23.71 (range $4.17 – $33.31)
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.

Other Providers at the Same Location NPPES 5

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

AMANDA CHAMBERS INGRAM NP
Nurse Practitioner (Primary Care)
304 SHORTER AVE NW STE 105
ROME, GA 30165
Floyd County (706) 290-9606
ROGENA D CORDLE MD
Pediatrics
304 SHORTER AVE NW STE 105
ROME, GA 30165
Floyd County (706) 291-4880
RICHARD TYLER BARNES MD
Pediatrics
304 SHORTER AVE NW STE 105
ROME, GA 30165
Floyd County (706) 291-4881
SYLVIA E WASHINGTON MD
Pediatrics
304 SHORTER AVE NW STE 105
ROME, GA 30165
Floyd County (706) 291-4880
KAREN P. TIMBERLAKE M.D.
Pediatrics
304 SHORTER AVE NW STE 105
ROME, GA 30165
Floyd County (706) 291-4880

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 Mark Boudreau's NPI number?

The NPI number for Mark Boudreau is 1659834323. It was assigned to this individual provider in the NPPES registry on April 10, 2019.

Where is Mark Boudreau located?

Mark Boudreau practices at 304 Shorter Ave NW Ste 105, Rome, GA 30165. The listed phone number is (706) 236-4880.

What is Mark Boudreau's specialty?

The primary specialty registered for this NPI is Pediatrics with taxonomy code 208000000X.

Is Mark Boudreau enrolled in Medicare?

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

What insurance does Mark Boudreau accept?

Health plans from Alliant Health Plans, Inc., Ambetter Health, Ambetter from Absolute Total Care, Ambetter of Alabama and Ambetter of North Carolina and 1 other insurer list Mark Boudreau as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Mark Boudreau was last updated on May 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.