MRS. NICOLE M BOUDREAUX PA-C
NPI 1699231894
Physician Assistant - Medical in Princess Anne, MD

Active since February 13, 2019PECOS EnrolledAccepts Medicare Assignment
58.76/100
CMS Quality Rating
12302 SOMERSET AVE STE AB, PRINCESS ANNE, MD 21853(410) 651-0300 Get Directions Write a Review

NPPES record last updated: December 27, 2023. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Jun 16, 2021, May 8, 2020, Feb 13, 2019 (3 updates tracked since 2019).

About Mrs. Nicole M Boudreaux Pa-c NPPES

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

MRS. NICOLE M BOUDREAUX PA-C (NPI 1699231894) is an individual medical provider in Princess Anne, Maryland, licensed in Maryland (C0007122) and active in the NPI registry since February 2019. She is enrolled in Medicare PECOS and is a graduate of Other (2018).

NPPES Registry Identity

NPI1699231894
Entity TypeIndividualFemale
Primary Taxonomy363AM0700X
Provider Legal NameMRS. NICOLE M BOUDREAUXCredential: PA-C
Location Address12302 SOMERSET AVE STE ABPrincess Anne, MD 21853-3099
Mailing Address34 Gatehouse TrlBerlin, MD 21811-2023 · (410) 490-9292
Sole ProprietorNo
Medical School CMSOtherGraduated 2018
Enumeration DateFebruary 13, 2019
Last NPPES UpdateDecember 27, 20233 updates tracked since enumeration
NPPES CertifiedDecember 27, 2023
NPI 1699231894 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

Primary SpecialtyPhysician Assistant · MedicalPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363AM0700X
License Licensed in MD · C0007122
Also ListedEmergency MedicineTaxonomy 207P00000X · License C0007122 (MD)
12302 SOMERSET AVE STE AB, Princess Anne, MD 21853

Other Names 1

Former Name (1)Ms. Nicole M Jones Pa-c

Other Identifiers 1

OtherC0007122MD · Maryland Medical License

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Mrs. Nicole M Boudreaux Pa-c is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2466791348
PECOS Enrollment IDI20190312001286
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.

Areas of Expertise CMS Part B claims 8

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
166 services144 patients
Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213
This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.
55 services53 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
37 services37 patients
Urinalysis, manual test 81002
A urinalysis is a simple, non-invasive test that checks the urine for various elements such as sugar, protein, and signs of infection. It can help detect many common conditions, including kidney disease and diabetes. The manual test involves a lab technician examining a urine sample.
35 services32 patients
Detection test by immunoassay with direct visual observation for influenza virus 87804
This is a test that identifies the influenza virus in your body. It works by using an immunoassay, a method that detects the presence of the virus through an immune response. The results are directly observable, making it a quick and efficient way to diagnose flu.
34 services16 patients
Detection test by immunoassay technique for severe acute respiratory syndrome coronavirus 87426
An immunoassay test for severe acute respiratory syndrome coronavirus is a diagnostic tool. It uses your body's immune response to detect the presence of the virus. It involves taking a sample, usually from your nose or throat, which is then analyzed in a lab for signs of the virus.
24 services22 patients

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

58.76/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality0
Improvement Activities40
Cost87.14

Other Providers at the Same Location NPPES 2

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

Physician Assistant
12302 SOMERSET AVE STE AB
PRINCESS ANNE, MD 21853
Nurse Practitioner (Family)
12302 SOMERSET AVE STE AB
PRINCESS ANNE, MD 21853

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 Nicole Boudreaux's NPI number?

The NPI number for Nicole Boudreaux is 1699231894. It was assigned to this individual provider in the NPPES registry on February 13, 2019. The provider is also known as Ms. Nicole M Jones Pa-C.

Where is Nicole Boudreaux located?

Nicole Boudreaux practices at 12302 Somerset Ave Ste Ab, Princess Anne, MD 21853. The listed phone number is (410) 651-0300.

What is Nicole Boudreaux's specialty?

The primary specialty registered for this NPI is Physician Assistant, specializing in Medical, with taxonomy code 363AM0700X.

Is Nicole Boudreaux enrolled in Medicare?

Yes. Nicole Boudreaux is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Nicole Boudreaux was last updated on December 27, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.