DR. CLARENCE E BOUDREAUX (M.D.) – Dermatology Physician, NPI 1053366211
Dermatology Physician
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
1,366 DERMATOLOGY in FL
Provider Addresses for DR. CLARENCE E BOUDREAUX (M.D.)
103 SOLANA ROAD SUITE B
PONTE VEDRA BEACH, FL 32082
Phone: (904) 273-2717
Fax: (904) 273-0410
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 6 Open Payments records for all available years, with a total value of $430.
Total Amount is formed as General ($430) + Research ($0) + Ownership ($0) = $430.
Last reported payment date: 2024-12-04 • Largest payer in this snapshot: ABBVIE INC. ($152).
Total Amount
$430
General + Research + Ownership
Payments
6
Total payment records
General Amount
$430
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-04
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2010-03-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20100310000499 | I | Dermatology | FL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| 17003 | Destruction of precancer skin growth, 2-14 growths | 376 | 82 | $0 |
| 88305 | Pathology examination of tissue using a microscope, intermediate complexity | 177 | 143 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 156 | 143 | $0 |
| 17000 | Destruction of precancer skin growth, 1 growth | 120 | 113 | $0 |
| 17110 | Destruction of skin growth, 1-14 growths | 66 | 65 | $0 |
Insurance plans in this area (ZIP 32082)
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Provider's Procedures
| Specialty | Practice State | HCPCS Code | Description | Service Count | Beneficiary Count |
|---|---|---|---|---|---|
| DERMATOLOGY | FL | 17003 | Destruction of 2-14 skin growths | 3480 | 632 |
Group practice members
| Name | Specialty | State |
|---|---|---|
| Physician Assistant | WI | |
| D E R M A T O L O G Y | FL | |
| Physician Assistant | OR | |
| D E R M A T O L O G Y | WA | |
| Physician Assistant | FL | |
| Physician Assistant | FL | |
| Physician Assistant | FL | |
| - | FL | |
| - | FL | |
| - | FL |
Reviews
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