Dr Clarence E Boudreaux, MD is a medicare enrolled "Dermatology" physician in Ponte Vedra Beach, Florida. He went to Louisiana State University School Of Medicine In New Orleans and graduated in 1985 and has 39 years of diverse experience with area of expertise as Dermatology. He is a member of the group practice Beaches Dermatology, P.a. and his current practice location is
103 Solana Road Suite B, Ponte Vedra Beach, Florida. You can reach out to his office (for appointments etc.) via phone at
(904) 273-2717.
Dr Clarence E Boudreaux is licensed to practice in Florida (license number ME0055674) and he also participates in the medicare program. He
accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1053366211.
Physician's Profile
| Full Name | Dr Clarence E Boudreaux |
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| Gender | Male |
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| Speciality | Dermatology |
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| Experience | 39 Years |
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| Location | 103 Solana Road Suite B, Ponte Vedra Beach, Florida |
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| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
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Medical Education and Training:
- Dr Clarence E Boudreaux attended and graduated from Louisiana State University School Of Medicine In New Orleans in 1985
NPI Data:
- NPI Number: 1053366211
- Provider Enumeration Date: 05/24/2006
- Last Update Date: 01/15/2010
Medicare PECOS Information:
- PECOS PAC ID: 7618012014
- Enrollment ID: I20100310000499
Medical Identifiers
Medical identifiers for Dr Clarence E Boudreaux such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1053366211 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207N00000X | Dermatology | ME0055674 (Florida) | Primary |
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Beaches Dermatology, P.a. | 9133190549 | 15 |
Medicare Reassignments
Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Dr Clarence E Boudreaux allows following entities to bill medicare on his behalf.
| Entity Name | Beaches Dermatology, P.a. |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1780627521
PECOS PAC ID: 9133190549
Enrollment ID: O20040802000141 |
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Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Clarence E Boudreaux is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
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Dr Clarence E Boudreaux, MD
103 Solana Road Suite B,
Ponte Vedra Beach, FL 32082
Ph: (904) 273-2717 | Dr Clarence E Boudreaux, MD
103 Solana Road Suite B,
Ponte Vedra Beach, FL 32082
Ph: (904) 273-2717 |
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