DR. JENNIFER BROOKE BOUDREAU MD
NPI 1811216021
Family Medicine in Leesburg, VA

Q: What is Jennifer Boudreau's NPI number?

The NPI number for Jennifer Boudreau is 1811216021. It was assigned to this individual provider in the NPPES registry on May 27, 2010. The provider is also known as Jennifer Brooke White MD.

Q: What is Jennifer Boudreau's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Jennifer Boudreau was last updated on October 13, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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 May 27, 2010PECOS EnrolledAccepts Medicare Assignment

540 FORT EVANS RD, SUITE 204, LEESBURG, VA 20176(703) 737-3500(703) 737-3550 Get Directions Write a Review

NPPES record last updated: October 13, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Dr. Jennifer Brooke Boudreau Md NPPES

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

DR. JENNIFER BROOKE BOUDREAU MD (NPI 1811216021) is an individual family medicine provider in Leesburg, Virginia, licensed in Virginia (0101258315) and active in the NPI registry since May 2010. She is enrolled in Medicare PECOS, is affiliated with Inova Loudoun Hospital, and is a graduate of Other (2010).

NPPES Registry Identity

NPI1811216021

Entity TypeIndividualFemale

Primary Taxonomy207Q00000X

Provider Legal NameDR. JENNIFER BROOKE BOUDREAUCredential: MD

Location Address540 FORT EVANS RD, SUITE 204Leesburg, VA 20176-3379

Mailing Address540 Fort Evans Rd, Suite 204Leesburg, VA 20176-3379 · (703) 737-3500 · Fax (703) 737-3550

Phone(703) 737-3500

Fax(703) 737-3550

Sole ProprietorNo

Medical School CMSOtherGraduated 2010

Enumeration DateMay 27, 2010

Last NPPES UpdateOctober 13, 2016

✔ NPI 1811216021 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Licenses✔ Licensed in VA · 0101258315✔ Licensed in WV · 25438

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

540 FORT EVANS RD, Leesburg, VA 20176

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Other Names 1

Former Name (1)Jennifer Brooke White Md

Other Identifiers 4

Medicaid3810026353WV

Medicare PINVV1253G155VA

Medicare PINVVI253C275VA

Medicare PINWV3186B987WV

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Jennifer Brooke Boudreau Md 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 ID2466696448

PECOS Enrollment IDI20150908002772

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 Jennifer Boudreau reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Vita Family Medicine And Medspa LLC

Same address

Family Medicine

540 FORT EVANS RD, SUITE 204
Leesburg, VA 20176

Reassigned Medicare billing, Virginia enrollment
2 clinicians in this Medicare group

NPI 1730532359 (703) 737-3500

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

Areas of Expertise CMS Part B claims 7

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.

321 services137 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.

84 services58 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

50 services50 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

22 services22 patients

Administration of influenza virus vaccine G0008

The administration of the influenza virus vaccine, also known as the flu shot, is a simple procedure to protect against the flu. A healthcare provider injects a small dose of the vaccine into your arm. This stimulates your immune system to produce antibodies, which will help your body fight off the flu if exposed.

19 services19 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.

15 services15 patients

Hospital Affiliations CMS Care Compare

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Inova Loudoun Hospital

Acute Care Hospitals · Leesburg, VA

5/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number490043

Location44045 Riverside ParkwayLeesburg, VA 20176 · Loudoun County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 20176 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

$86.88 typical visit price

range $56.19 – $170.30

Typical copayment $21.72 (range $14.04 – $42.57)

Most-billed visit code 99203

Established Patient

$99.13 typical visit price

range $18.07 – $138.91

Typical copayment $24.78 (range $4.51 – $34.72)

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 10

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

LEESBURG SPORTS, INC.

Clinic/Center (Rehabilitation)

540 FORT EVANS RD, SUITE 206
LEESBURG, VA 20176

Loudoun County (703) 777-1026

DR. JOSEPH PETER SWEHLA DPT, PT

Physical Therapist

540 FORT EVANS RD
LEESBURG, VA 20176

Loudoun County (703) 777-1026

DR. SANDRA VARNEY DDS

Dentist (General Practice)

540 FORT EVANS RD, SUITE 100
LEESBURG, VA 20176

Loudoun County (703) 779-7779

LYBA KHAN PA

Physician Assistant

540 FORT EVANS RD
LEESBURG, VA 20176

Loudoun County (703) 737-3500

LEGACY ORTHODONTICS, PLC

Dentist (Orthodontics and Dentofacial Orthopedics)

540 FORT EVANS RD, 102
LEESBURG, VA 20176

Loudoun County (703) 777-8277

YUEH YEE WONG DPT

Physical Therapist

540 FORT EVANS RD, SUITE 206
LEESBURG, VA 20176

Loudoun County (703) 777-1026

DRS. VARNEY & LEIPZIG, PLC

Dentist

540 FORT EVANS RD, SUITE 100
LEESBURG, VA 20176

Loudoun County (703) 779-7779

VITA FAMILY MEDICINE AND MEDSPA LLC

Family Medicine

540 FORT EVANS RD, SUITE 204
LEESBURG, VA 20176

Loudoun County (703) 737-3500

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 Jennifer Boudreau's NPI number?

The NPI number for Jennifer Boudreau is 1811216021. It was assigned to this individual provider in the NPPES registry on May 27, 2010. The provider is also known as Jennifer Brooke White MD.

Where is Jennifer Boudreau located?

Jennifer Boudreau practices at 540 Fort Evans Rd Suite 204, Leesburg, VA 20176. The listed phone number is (703) 737-3500.

What is Jennifer Boudreau's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Jennifer Boudreau enrolled in Medicare?

Yes. Jennifer Boudreau 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.

Which organization bills Medicare for Jennifer Boudreau's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Jennifer Boudreau reassigns Medicare benefits to Vita Family Medicine And Medspa LLC (Leesburg, VA). 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 Jennifer Boudreau's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Jennifer Boudreau affiliated with any hospitals?

According to CMS data, Jennifer Boudreau is affiliated with Inova Loudoun Hospital.

When was this NPI record last updated?

The NPPES record for Jennifer Boudreau was last updated on October 13, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.