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Dr. Mark Ricard Boudreau , DO

Pediatrics β€’ Rome, GA

Active NPI 1659834323 Individual Practitioner Male Practitioner
Practice location in NPPES

304 Shorter Ave Nw Ste 105
Rome, GA 301654256

Call 7062364880 Location details and other listings
Medical Disclaimer

This profile restates public CMS/NPPES data; T-MedInfo gives no medical advice — consult a licensed professional, and call 911 for emergencies.

Practice Location & Contact Primary Location

Practice Address

304 Shorter Ave Nw Ste 105

Rome, GA 301654256

Telephone 7062364880
Organization at the Same NPPES Address or Phone
Floyd Cherokee Medical Center Llc Facility NPI 1003430893

Matched by practice address or phone in NPPES. A shared address or phone does not confirm that this clinician works there.

Other Listings in Public Data

NPPES lists 1 additional practice-address record in Cedartown, GA. See the list

Source: CMS NPPES NPI Registry, practice location records; release date unavailable.

Listings do not confirm current availability, employment or a shared ownership network.

Industry payments (Open Payments)

Fewer than 11 payment records totaling $15.17 in 2023

Drug and medical device companies must report certain payments to doctors and some other clinicians to CMS, such as meals, travel, speaking fees or research funding.

These records are submitted by drug and medical device companies, and a reported payment does not necessarily mean the financial relationship is improper.

General: payments not tied to research, such as meals, travel, consulting or speaking fees.

A reported payment does not necessarily mean the financial relationship is improper. Research payments can go to a hospital or university for a study the clinician leads, not to the clinician personally. Clinicians can dispute records with the company that reported them.

Source: CMS Open Payments, program year 2023.

Guide: How to read an Open Payments record

NPI first issued

2019

The year this clinician's National Provider Identifier (NPI) was issued. An NPI is a unique 10-digit ID that US health care providers use for billing.

What this does not show: NPI first issued

NPIs have been issued only since 2005, so this year is not necessarily when the clinician started practicing.

Source: CMS NPPES NPI Registry.

Medicare assignment not listed

CMS data do not show whether this clinician accepts Medicare assignment. This does not mean they do not accept Medicare. Ask the office.

Medicare assignment applies to Original Medicare. It does not tell you whether the clinician is in a Medicare Advantage plan's network, accepts other insurance, or is taking new patients.

Source: CMS Doctors and Clinicians; Medicare.gov, β€œDoes your provider accept Medicare as full payment?”

Guide: What Medicare assignment means

No telehealth indicator

CMS shows this indicator only when recent Medicare claims include telehealth services. The clinician may still offer telehealth; ask the office.

Source: CMS, Telehealth Indicator on Medicare Care Compare (fact sheet, January 2023); CMS Doctors and Clinicians.

Guide: How Medicare covers telehealth

Enrolled in Medicare (PECOS)

Dr. Boudreau has a Medicare enrollment record in PECOS, the CMS system clinicians use to enroll so they can bill Medicare or order services for people with Medicare.

It does not show whether the clinician accepts assignment, is in your plan's network, or is taking new patients.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What Medicare enrollment (PECOS) means

Can order Medicare-covered services

CMS lists Dr. Boudreau as eligible to order or refer Medicare Part B clinical laboratory and imaging services, durable medical equipment (DME) and home health services for people with Medicare.

What this does not show: Can order Medicare-covered services

It does not mean the clinician offers these services directly.

Source: CMS Medicare Fee-For-Service Public Provider Enrollment (PECOS); CMS Order and Referring file.

Guide: What ordering and referring status means

Compared with the same specialty in Rome and Georgia

19 active clinicians are listed under Pediatrics with a practice address in Rome, GA (2,258 in Georgia).

Addresses are self-reported to NPPES and may be out of date.

Telehealth indicator in Rome

0% of these 19 clinicians have the CMS telehealth indicator.

5.3% of these 19 clinicians are listed by CMS as accepting Medicare assignment.

Sources: CMS Open Payments (2023), CMS Doctors and Clinicians, CMS NPPES NPI Registry. Specialty names follow the NUCC Health Care Provider Taxonomy.

Text: T-MedInfo Β· Report an error.

Pharma & Medical Device Financial Disclosures

Payments and other transfers of value that drug and medical device companies reported to CMS Open Payments

Open Payments Β· Program Year 2023

Program year 2023 (payments made January 1 – December 31, 2023): fewer than 11 records totaling $15.17.

Manufacturer Payment Nature Product Type Amount ($)
ABBVIE INC.
Food and Beverage
In-kind items and services
UBRELVY General $15.17

Source: CMS Open Payments, program year 2023, released June 30, 2026.

Specialties & License Numbers Reported to NPPES

Self-certified to NPPES: 2023-05-26
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

License # reported to NPPES GA 11273

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Check License Status with the State Board License numbers are self-reported to NPPES; T-MedInfo does not confirm them against state records. Current status: Georgia Composite Medical Board.
Look Up on State Board Site

Medicare (PECOS) Enrollment & Ordering Eligibility

Source: CMS PECOS
Medicare FFS Enrollment Status Medicare Enrollment on File
CMS Provider Specialty

PRACTITIONER - PEDIATRIC MEDICINE

Medicare Enrollment ID

I20220811001211

Enrollment State Jurisdiction

GA

PECOS Control ID

5597093146

Medicare Order & Referring Eligibility
Clinical Lab & Imaging (Part B) Eligible
Durable Medical Equipment (DME) Eligible
Home Health Agency (HHA) Eligible
Power Mobility Devices (PMD) Eligible

Sources: CMS Provider Enrollment and Order and Referring. Medicare enrollment is a billing status, not an accreditation or quality rating.

Secondary Practice Locations

2370 Rockmart Hwy Ste 100

Cedartown, GA 301256029

Phone: 7707487818

Clinicians Sharing This Practice Address or Phone

Clinicians sharing this NPPES address, phone or fax; a shared contact does not mean they work together.

1 listed
Amanda Ingram , NP

Nurse Practitioner - Primary Care

NPI 1558856401

Nurse Practitioner

Career & Practice History Timeline

Changes recorded in monthly NPPES data files: addresses, names, credentials, specialties and NPI status

14 Historical Events
πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) March 07, 2023

Pediatrics (license number reported to NPPES: GA 11273)

πŸ“
Updated Practice Location November 17, 2022

Registered at 304 SHORTER AVE NW STE 105, ROME, GA 301654256 (Tel: 7062364880)

πŸ“
Updated Practice Location August 08, 2022

Registered at 2370 ROCKMART HWY STE 100, CEDARTOWN, GA 301256029 (Tel: 7707487818)

πŸ“
Updated Business Mailing Address August 08, 2022

Registered at 420 E 2ND AVE STE 103, ROME, GA 301613210 (Tel: 7065093000)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) August 08, 2022

Student in an Organized Health Care Education/Training Program

πŸ“
Updated Practice Location July 11, 2019

Registered at 744 1ST ST, MACON, GA 312016840 (Tel: 4786337500)

πŸ“
Updated Business Mailing Address July 11, 2019

Registered at 744 1ST ST, MACON, GA 312016840 (Tel: 4786337500)

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) July 11, 2019

Pediatrics (license number reported to NPPES: GA 11273)

βœ…
NPI Profile Active April 10, 2019

NPI status registered as active in NPPES database

πŸ“
Practice Location (Initial Record) April 10, 2019

Registered at 777 HEMLOCK STREET, MACON, GA 31201 (Tel: 4786331634)

πŸ“
Business Mailing Address (Initial Record) April 10, 2019

Registered at 11302 DEEP POND DR, COLLIERVILLE, TN 38017 (Tel: 9018718688)

πŸ‘€
Provider Name / Credentials (Initial Record) April 10, 2019

Recorded as MARK BOUDREAU, DO

πŸŽ“
Medical Taxonomy / Specialty Registered (Primary Specialty) April 10, 2019

Student in an Organized Health Care Education/Training Program

🟒
Initial NPI Registration & Enumeration April 10, 2019

First registered as active Individual Practitioner in NPPES Database.

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NPI Administrative Meta

NPI Number: 1659834323
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: April 10, 2019
Last Update: May 26, 2023
Sole Proprietor: No

Other Pediatrics Specialists in Rome

Healthcare providers in Rome

Mailing Address

420 E 2nd Ave Ste 103

Rome, GA 301613210

Phone: 7065093000

About This Data NPPES fields (address, phone, specialty, license) are self-reported and may be outdated; Medicare fields follow the CMS dataset named in each section. Correct directly at NPPES.