Dr Edward David Boudreau, DO is a medicare enrolled "Family Medicine" physician in Cheyenne Wells, Colorado. He went to Michigan State University College Of Osteopathic Medicine and graduated in 1977 and has 47 years of diverse experience with area of expertise as Emergency Medicine. He is a member of the group practice Keefe Memorial Health Service District and his current practice location is
615 W 5th St N, Cheyenne Wells, Colorado. You can reach out to his office (for appointments etc.) via phone at
(719) 767-5661.
Dr Edward David Boudreau is licensed to practice in Colorado (license number DR.0063534) 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 1528014461.
Physician's Profile
| Full Name | Dr Edward David Boudreau |
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| Gender | Male |
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| Speciality | Emergency Medicine |
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| Experience | 47 Years |
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| Location | 615 W 5th St N, Cheyenne Wells, Colorado |
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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 Edward David Boudreau attended and graduated from Michigan State University College Of Osteopathic Medicine in 1977
NPI Data:
- NPI Number: 1528014461
- Provider Enumeration Date: 05/25/2006
- Last Update Date: 12/05/2023
Medicare PECOS Information:
- PECOS PAC ID: 9638073067
- Enrollment ID: I20201125002353
Medical Identifiers
Medical identifiers for Dr Edward David Boudreau such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
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| 1528014461 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
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| 207P00000X | Emergency Medicine | 0063534 (Colorado) | Secondary |
| 207Q00000X | Family Medicine | DR.0063534 (Colorado) | Primary |
Medical Facilities Affiliation
Group Practice Association
| Group Practice Name | Group PECOS PAC ID | No. of Members |
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| Keefe Memorial Health Service District | 8325364441 | 11 |
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 Edward David Boudreau allows following entities to bill medicare on his behalf.
| Entity Name | Keefe Memorial Health Service District |
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| Entity Type | Part B Supplier - Clinic/group Practice |
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| Entity Identifiers | NPI Number: 1366840688
PECOS PAC ID: 8325364441
Enrollment ID: O20150309002177 |
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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 Edward David Boudreau 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 Edward David Boudreau, DO
Po Box 578,
Cheyenne Wells, CO 80810-0578
Ph: (719) 767-5662 | Dr Edward David Boudreau, DO
615 W 5th St N,
Cheyenne Wells, CO 80810
Ph: (719) 767-5661 |
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