DR. EDWARD DAVID BOUDREAU (D.O.) – Emergency Medicine Physician, NPI 1528014461
Emergency Medicine Physician
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Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
2,673 EMERGENCY MEDICINE in OH
Provider Addresses for DR. EDWARD DAVID BOUDREAU (D.O.)
689 Radio Dr
Lewis Center, OH 430357132
Phone: (614) 805-9595
Type: Location
615 W 5TH ST N
CHEYENNE WELLS, CO 80810
Phone: (719) 767-5661
Fax: (719) 767-5098
Type: Location
The Staebler Group, 575, Copeland Mill Road, Westerville, Sharon, Franklin, Ohio, 43081, United States
SUITE #1D
WESTERVILLE, OH 430818977
Phone: (614) 794-0481
Fax: (614) 794-3711
Type: Mailing
Mount Carmel Saint Ann's Hospital, 500, South Cleveland Avenue, Westerville, Sharon, Franklin, Ohio, 43081, United States
WESTERVILLE, OH 430818971
Phone: (614) 794-0481
Fax: (614) 794-3711
Type: Location
PO BOX 578
CHEYENNE WELLS, CO 808100578
Phone: (614) 805-9595
Fax: (719) 451-3423
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: 2023-01-10
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 5 Medicare enrollment records; no due dates published yet.
Enrollment records
5
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 |
|---|---|---|---|---|
| I20031208000016 | I | Emergency Medicine | OH | TBD |
| I20100924000892 | I | Emergency Medicine | NC | TBD |
| I20140723002752 | I | Emergency Medicine | ME | TBD |
| I20201125002353 | I | Emergency Medicine | CO | TBD |
| I20230110002423 | I | Emergency Medicine | AZ | 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 |
|---|---|---|---|---|
| 99284 | Emergency department visit with moderate level of medical decision making | 24 | 17 | $0 |
| 99238 | Hospital discharge day management, 30 minutes or less | 16 | 16 | $0 |
| 99283 | Emergency department visit with low level of medical decision making | 15 | 15 | $0 |
| 99222 | Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes | 14 | 14 | $0 |
Insurance plans in this area (ZIP 43035)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Nurse Practitioner | KS | |
| Nurse Practitioner | CO | |
| Nurse Practitioner | IL | |
| Emergency Medicine | CO | |
| Nurse Practitioner | WV | |
| Emergency Medicine, Family Practice | AZ | |
| Emergency Medicine | CO | |
| Nurse Practitioner | CO | |
| Nurse Practitioner | CO | |
| Mental Health Counselor | IL |
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