MR. EDWARD J BOUDREAU (PT, OCS) – Orthopedic Physical Therapist, NPI 1043395007
Orthopedic Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for MR. EDWARD J BOUDREAU (PT, OCS)
16, Hayden Avenue, Lexington, Middlesex County, Massachusetts, 20421, United States
LEXINGTON, MA 024217929
Phone: (781) 372-7000
Type: Location
131, Collins Street, Tapleyville, Danvers, Essex County, Massachusetts, 01923, United States
DANVERS, MA 019233537
Phone: (978) 766-0880
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
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: 2018-01-17
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 |
|---|---|---|---|---|
| I20180117002202 | I | Physical Therapist In Private Practice | MA | 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 |
|---|---|---|---|---|
| 97110 | Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes | 333 | 57 | $0 |
| 97140 | Therapy procedure using manual technique, each 15 minutes | 89 | 21 | $0 |
| 97112 | Therapy procedure to re-educate brain-to-nerve-to-muscle function, each 15 minutes | 42 | 11 | $0 |
| 97161 | Evaluation for physical therapy, typically 20 minutes | 28 | 28 | $0 |
| 97162 | Evaluation for physical therapy, typically 30 minutes | 12 | 12 | $0 |
Insurance plans in this area (ZIP 02421)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | MA | |
| - | MA | |
| G A S T R O E N T E R O L O G Y | NY | |
| Physician Assistant | MA | |
| A N E S T H E S I O L O G Y | MA |
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