MARK RICARD BOUDREAU JR. DO
NPI 1659834323
Pediatrics in Rome, GA
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
Specialties & Licenses
Secondary Practice Location 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Mark Ricard Boudreau Jr. Do is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Mark Boudreau reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Rome, GA 30165
- Reassigned Medicare billing, Georgia enrollment
- 232 clinicians in this Medicare group
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 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.
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.
ROME, GA 30165
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.
Which organization bills Medicare for Mark Boudreau's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Mark Boudreau reassigns Medicare benefits to Floyd Healthcare Management Inc (Rome, GA). 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 Mark Boudreau's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
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 3 other insurers 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.
# Mark Ricard Boudreau Jr., DO · NPI 1659834323
Pediatrics physician in Rome, Georgia. Individual provider, active in the CMS NPPES registry since April 10, 2019.
## Identity
- **NPI:** 1659834323 (Entity type: Individual)
- **Enumerated:** April 10, 2019
- **Primary specialty:** Pediatrics · taxonomy 208000000X
- **State license:** 11273 (Georgia)
- **Sole proprietor:** No
## Practice location
- **Address:** 304 SHORTER AVE NW STE 105, Rome, GA 30165-4256
- **Phone:** (706) 236-4880
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** Floyd Healthcare Management Inc (NPI 1023057775, Rome, GA), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** May 26, 2023
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Source: [NPI Profile](https://npiprofile.com/npi/1659834323) · Data from the CMS NPPES public registry.