| Nathan J Ambrose, PA | |
|
5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA 70508-6984 | |
| (337) 470-3580 | |
| (337) 470-3586 |
| Full Name | Nathan J Ambrose |
|---|---|
| Gender | Male |
| Speciality | Physician Assistant |
| Experience | 6 Years |
| Location | 5000 Ambassador Caffery Pkwy Ste A, Lafayette, Louisiana |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326694076 | NPI | - | NPPES |
| 058924-PA | Other | LA | CDS |
| 324792 | Other | LA | STATE LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AS0400X | Physician Assistant - Surgical | 324792 (Louisiana) | Primary |
| 390200000X | Student In An Organized Health Care Education/training Program | (NU) | Secondary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Our Lady Of Lourdes Regional Medical Center, Inc | Lafayette, LA | Hospital |
| Intermountain Health St. Mary's Regional Hospital | Grand junction, CO | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Intermountain Medical Group Grand Junction, Llc | 3779707856 | 297 |
| Lourdes Physician Group Llc | 7214177757 | 157 |
| Entity Name | Intermountain Medical Group Grand Junction, LLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1356765556 PECOS PAC ID: 3779707856 Enrollment ID: O20140611000363 |
| Mailing Address | Practice Location Address |
|---|---|
| Nathan J Ambrose, PA 1132 Gather Dr, Lawrenceville, GA 30043-7549 Ph: (810) 625-4218 | Nathan J Ambrose, PA 5000 Ambassador Caffery Pkwy Ste A, Lafayette, LA 70508-6984 Ph: (337) 470-3580 |
Stefanie Hummel Theriot, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 105 Patriot St Ste 101, Lafayette, LA 70508 Phone: 337-981-2125 Fax: 337-981-2174 |
Kevin Kathleen M Menard, PA Physician Assistant Medicare: May Accept Medicare Assignments Practice Location: 1103 Kaliste Saloom Rd, Lafayette, LA 70508 Phone: 337-234-5234 |
Todd A Devalcourt, P.A. Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4212 W Congress St Ste 3100, Lafayette, LA 70506 Phone: 337-703-3201 Fax: 337-703-3202 |
Banee Madison, P.A Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4600 Ambassador Caffery Pkwy, Lafayette, LA 70508 Phone: 337-561-9100 |
Ms. Justine Michelle Guerrero, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 901 Wilson St, Lafayette, LA 70503 Phone: 337-456-6523 Fax: 337-456-6521 |
Mrs. Sarah Lalande Ardoin, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508 Phone: 337-470-2605 Fax: 337-470-4595 |
Jason R Comeaux, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 4801 Ambassador Caffery Pkwy, Lafayette, LA 70508 Phone: 337-470-2605 Fax: 337-470-4595 |