JOHN ANTHONY BOUDREAU (MD) – Orthopaedic Surgery Physician, NPI 1053338640
Orthopaedic Surgery Physician
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
802 ORTHOPEDIC SURGERY in MO
Provider Addresses for JOHN ANTHONY BOUDREAU (MD)
3691 RUTGER AVE
PROVIDER ENROLLMENT
ST LOUIS, MO 63110
Phone: (314) 977-4440
Type: Mailing
1201 S GRAND BLVD
SAINT LOUIS, MO 631041016
Phone: (314) 257-8000
Fax: (314) 268-5121
Type: Location
SSM Health Saint Louis University Hospital, 3635, Vista Avenue, Tiffany, City of Saint Louis, Missouri, 63110, United States
7TH FLOOR DESLOGE TOWERS
ST LOUIS, MO 63110
Phone: (314) 577-8855
Fax: (314) 268-5121
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 11 Open Payments records for all available years, with a total value of $533.
Total Amount is formed as General ($533) + Research ($0) + Ownership ($0) = $533.
Last reported payment date: 2024-12-21 • Largest payer in this snapshot: DePuy Synthes Sales Inc. ($325).
Total Amount
$533
General + Research + Ownership
Payments
11
Total payment records
General Amount
$533
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-21
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| DePuy Synthes Sales Inc. | $325 |
| OsteoCentric Technologies, Inc. | $75 |
| Stryker Corporation | $47 |
| Sirtex Medical Inc | $39 |
| Organogenesis Inc. | $24 |
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: 2006-11-28
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 |
|---|---|---|---|---|
| I20061128000172 | I | Orthopedic Surgery | MO | 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 |
|---|---|---|---|---|
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 39 | 22 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 15 | 15 | $0 |
Insurance plans in this area (ZIP 63110)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Pain Management, Physical Medicine And Rehabilitation, Orthopedic Surgery | IL | |
| N E U R O L O G Y | MO | |
| Internal Medicine | MO | |
| Physician Assistant | MO | |
| Internal Medicine, Hospitalist | MO | |
| Internal Medicine, Infectious Disease | MO | |
| P O D I A T R Y | MO | |
| Family Practice, Hospitalist | MO | |
| O B S T E T R I C S/ G Y N E C O L O G Y | MO | |
| P O D I A T R Y | IL |
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