| Mayfair Physician Services, Llc | |
| 
					17000 Medical Center Dr Baton Rouge LA 70816-3246  | |
| (225) 752-2470 | |
| Not Available | 
| Full Name | Mayfair Physician Services, Llc | 
|---|---|
| Speciality | Hospitalist | 
| Location | 17000 Medical Center Dr, Baton Rouge, Louisiana | 
| Authorized Official Name and Position | Lisha C Falk (VP OF CONTRACTING) | 
| Authorized Official Contact | 3376091221 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mayfair Physician Services, Llc 200 Corporate Blvd Lafayette LA 70508-3870 Ph: (800) 893-9698  | Mayfair Physician Services, Llc 17000 Medical Center Dr Baton Rouge LA 70816-3246 Ph: (225) 752-2470  | 
| NPI Number | 1831688365 | 
|---|---|
| Provider Enumeration Date | 05/10/2018 | 
| Last Update Date | 11/04/2022 | 
| Medicare PECOS PAC ID | 7618225814 | 
|---|---|
| Medicare Enrollment ID | O20180803002194 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1831688365 | NPI | - | NPPES | 
| 2475801 | Medicaid | LA | 
| Provider Name | Majid A Jawad | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1558316596 PECOS PAC ID: 5597664417 Enrollment ID: I20040108000629  | 
| Provider Name | Barbara J Liscum | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1720084510 PECOS PAC ID: 2961499959 Enrollment ID: I20040430000058  | 
| Provider Name | Laura Entrekin | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1518930072 PECOS PAC ID: 1052397866 Enrollment ID: I20040624000618  | 
| Provider Name | Caxton Opere | 
|---|---|
| Provider Type | Practitioner - Emergency Medicine | 
| Provider Identifiers | NPI Number: 1073614723 PECOS PAC ID: 9931163722 Enrollment ID: I20041111001015  | 
| Provider Name | Shameem Akhtar | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1720184328 PECOS PAC ID: 2567469240 Enrollment ID: I20061024000069  | 
| Provider Name | Fadi Hawawini | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1124236690 PECOS PAC ID: 1254430093 Enrollment ID: I20070620000378  | 
| Provider Name | Brad David Vincent | 
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) | 
| Provider Identifiers | NPI Number: 1588747406 PECOS PAC ID: 4183717614 Enrollment ID: I20070829000605  | 
| Provider Name | Rachel A Aaron | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1265636658 PECOS PAC ID: 8426141854 Enrollment ID: I20070830000604  | 
| Provider Name | Mohammad Zohair Pirzadah | 
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) | 
| Provider Identifiers | NPI Number: 1841286077 PECOS PAC ID: 6709975485 Enrollment ID: I20071203000655  | 
| Provider Name | John E Rogers | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1609899319 PECOS PAC ID: 7012091770 Enrollment ID: I20080220000253  | 
| Provider Name | Robyn L Boedefeld | 
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) | 
| Provider Identifiers | NPI Number: 1467407577 PECOS PAC ID: 5193766996 Enrollment ID: I20080808000279  | 
| Provider Name | Jared F Collins | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1205026143 PECOS PAC ID: 1951450550 Enrollment ID: I20090529000464  | 
| Provider Name | Ijeoma N Innocent-ituah | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1184824633 PECOS PAC ID: 4981758638 Enrollment ID: I20090815000013  | 
| Provider Name | Stephanie M Cook | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1578796025 PECOS PAC ID: 4688720956 Enrollment ID: I20090929000219  | 
| Provider Name | Jennifer A Burtch | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1205074374 PECOS PAC ID: 6901948553 Enrollment ID: I20100121000100  | 
| Provider Name | Pamela P Tremblay | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1225058613 PECOS PAC ID: 1658416581 Enrollment ID: I20100303000848  | 
| Provider Name | Cherie M Bagwell | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1801125448 PECOS PAC ID: 1355477084 Enrollment ID: I20100331001120  | 
| Provider Name | Rene Yvonne Meadows | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1467404681 PECOS PAC ID: 7911034723 Enrollment ID: I20100428000302  | 
| Provider Name | Erica A Diggs | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1033176169 PECOS PAC ID: 1951439553 Enrollment ID: I20100430000672  | 
| Provider Name | John Nnadi | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1558506782 PECOS PAC ID: 8921138546 Enrollment ID: I20100608000868  | 
| Provider Name | James Ratliff | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1457594400 PECOS PAC ID: 7517006315 Enrollment ID: I20100610000860  | 
| Provider Name | William Oren Blalock | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1073570479 PECOS PAC ID: 9537290325 Enrollment ID: I20100622000806  | 
| Provider Name | Gillian Ann Ellis | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1811196215 PECOS PAC ID: 7719026459 Enrollment ID: I20100706000717  | 
| Provider Name | Jason B Hill | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1891016929 PECOS PAC ID: 5294867230 Enrollment ID: I20100709000608  | 
| Provider Name | Fiona A. Winterbottom | 
|---|---|
| Provider Type | Practitioner - Certified Clinical Nurse Specialist (cns) | 
| Provider Identifiers | NPI Number: 1679891808 PECOS PAC ID: 6608908322 Enrollment ID: I20100715000905  | 
| Provider Name | Ranada Ann Johnson | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1790976140 PECOS PAC ID: 6103959457 Enrollment ID: I20100806000311  | 
| Provider Name | Melanie Jeanne Mcknight | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1073546149 PECOS PAC ID: 9739096538 Enrollment ID: I20100811000877  | 
| Provider Name | Vijay Thumma | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1982895827 PECOS PAC ID: 6002008836 Enrollment ID: I20101012000199  | 
| Provider Name | Amanda Boudreau Dupre | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1962719369 PECOS PAC ID: 6002002771 Enrollment ID: I20101119000665  | 
| Provider Name | Shahed M Jameel | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1902002850 PECOS PAC ID: 0648466631 Enrollment ID: I20101202000820  | 
| Provider Name | Lisa Plauche | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1538460845 PECOS PAC ID: 9931397817 Enrollment ID: I20101220000057  | 
| Provider Name | Pallavi Sunkara | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1184902348 PECOS PAC ID: 8224207873 Enrollment ID: I20110816000546  | 
| Provider Name | Heather Shunta Hill | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1629240999 PECOS PAC ID: 8729259122 Enrollment ID: I20110915000096  | 
| Provider Name | Nikhil Sharma | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1730316522 PECOS PAC ID: 5991960338 Enrollment ID: I20120710000058  | 
| Provider Name | Jeremiah H Newsom | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1245434612 PECOS PAC ID: 9638222003 Enrollment ID: I20120724000086  | 
| Provider Name | Mirza K Baig | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1346483708 PECOS PAC ID: 8729234620 Enrollment ID: I20120808000830  | 
| Provider Name | Nicole Allen | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1801158886 PECOS PAC ID: 3870743487 Enrollment ID: I20121017000125  | 
| Provider Name | Charit A Fares | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1194952119 PECOS PAC ID: 7113178880 Enrollment ID: I20121107000188  | 
| Provider Name | Lan Ta | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1760619563 PECOS PAC ID: 9234382565 Enrollment ID: I20130116000391  | 
| Provider Name | Gloria V Peters | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1972844769 PECOS PAC ID: 7618113200 Enrollment ID: I20130427000043  | 
| Provider Name | Christine Z Hadeed | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1750726006 PECOS PAC ID: 8820238959 Enrollment ID: I20130712000288  | 
| Provider Name | Jeffrey Ryan Mcmahon | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1518208073 PECOS PAC ID: 5799926358 Enrollment ID: I20130724000070  | 
| Provider Name | Hassan A Fares | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1114246105 PECOS PAC ID: 2961644752 Enrollment ID: I20130807000297  | 
| Provider Name | Laura Bateman | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1316267370 PECOS PAC ID: 0143462994 Enrollment ID: I20130807001011  | 
| Provider Name | Wesley Todd Ross | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1235578212 PECOS PAC ID: 6103069034 Enrollment ID: I20130826000296  | 
| Provider Name | Nicole Culbert Miles | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1356771240 PECOS PAC ID: 1052549730 Enrollment ID: I20140103000150  | 
| Provider Name | Pamela J. Woods | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1053734574 PECOS PAC ID: 2860623642 Enrollment ID: I20140319001495  | 
| Provider Name | Dreshellia Monquellia Hargrave | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1235552548 PECOS PAC ID: 8325271703 Enrollment ID: I20140509001178  | 
| Provider Name | Palvi Patel | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1578705620 PECOS PAC ID: 7719143809 Enrollment ID: I20140714000978  | 
| Provider Name | James C Mckay | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1487681169 PECOS PAC ID: 0941202337 Enrollment ID: I20140930003083  | 
| Provider Name | Matthew Mcclanahan | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1609175579 PECOS PAC ID: 2062653389 Enrollment ID: I20150730013475  | 
| Provider Name | Kiran Garikapati | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1508111634 PECOS PAC ID: 0244462117 Enrollment ID: I20150828000281  | 
| Provider Name | Michael Cassidy Hogan | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1194100891 PECOS PAC ID: 6901114008 Enrollment ID: I20151008002017  | 
| Provider Name | Tarek Abdallah | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1912142761 PECOS PAC ID: 8123171980 Enrollment ID: I20151024000169  | 
| Provider Name | Edgar Pumarol Castillo | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1285981183 PECOS PAC ID: 1557502788 Enrollment ID: I20151110002901  | 
| Provider Name | Ena Jackson Lacy | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1750754172 PECOS PAC ID: 6709187222 Enrollment ID: I20151228002326  | 
| Provider Name | Pamela H. Stanley | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1003273574 PECOS PAC ID: 8426355827 Enrollment ID: I20160330001797  | 
| Provider Name | Kaysie L Boudreaux | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1598120370 PECOS PAC ID: 1052610243 Enrollment ID: I20160421001719  | 
| Provider Name | Andrea B Bourque | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1861851057 PECOS PAC ID: 0648560227 Enrollment ID: I20160610000179  | 
| Provider Name | Brandon M Weeks | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1366735748 PECOS PAC ID: 8325266604 Enrollment ID: I20160908000062  | 
| Provider Name | Madeleine T Nguyen | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1164765285 PECOS PAC ID: 8022308576 Enrollment ID: I20160924000040  | 
| Provider Name | Andrew John Streicher | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1033426846 PECOS PAC ID: 9133363880 Enrollment ID: I20161017000549  | 
| Provider Name | Kortney Stinson | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1437693751 PECOS PAC ID: 3072895887 Enrollment ID: I20170131000038  | 
| Provider Name | Manuel Vargas | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1366838948 PECOS PAC ID: 8527341494 Enrollment ID: I20170306001233  | 
| Provider Name | Margaret E Browder | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1134477292 PECOS PAC ID: 5597067694 Enrollment ID: I20170320002084  | 
| Provider Name | Kassidy Ann Johnson | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1235675257 PECOS PAC ID: 6901181502 Enrollment ID: I20170322001526  | 
| Provider Name | Jennifer M Minadeo | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1093007593 PECOS PAC ID: 8820218134 Enrollment ID: I20170411002695  | 
| Provider Name | Heather H Chau | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1144647298 PECOS PAC ID: 9234435264 Enrollment ID: I20170717001277  | 
| Provider Name | David Michael Ourso | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1245771385 PECOS PAC ID: 6709156672 Enrollment ID: I20170726000183  | 
| Provider Name | Heather P Kahn | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1972920866 PECOS PAC ID: 5496974610 Enrollment ID: I20170803002205  | 
| Provider Name | Riza E Cruz | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1174933030 PECOS PAC ID: 6507164878 Enrollment ID: I20171014000047  | 
| Provider Name | Barbara Denise Franceski | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1134377187 PECOS PAC ID: 0749342343 Enrollment ID: I20171221000342  | 
| Provider Name | April Joy Normand | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1861909525 PECOS PAC ID: 4789945437 Enrollment ID: I20180221001121  | 
| Provider Name | Aungelle Michelle Lytell | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1548768856 PECOS PAC ID: 9133482300 Enrollment ID: I20180423000527  | 
| Provider Name | Ashley G Ingolia | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1578959631 PECOS PAC ID: 8426377128 Enrollment ID: I20180620001008  | 
| Provider Name | Clinton Joseph Alombro | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1831585553 PECOS PAC ID: 7113229303 Enrollment ID: I20180720002243  | 
| Provider Name | Arekeva Theodore-selmon | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1467965228 PECOS PAC ID: 8426305087 Enrollment ID: I20180727001961  | 
| Provider Name | Molly Beth Delk | 
|---|---|
| Provider Type | Practitioner - Gastroenterology | 
| Provider Identifiers | NPI Number: 1679967236 PECOS PAC ID: 2365737087 Enrollment ID: I20180801003776  | 
| Provider Name | Dipti G Munshi | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1699162065 PECOS PAC ID: 5799092656 Enrollment ID: I20180803000541  | 
| Provider Name | Tyesha Taylor | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1053800599 PECOS PAC ID: 8820346943 Enrollment ID: I20180807001356  | 
| Provider Name | Elizabeth King | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1235621475 PECOS PAC ID: 3870841778 Enrollment ID: I20180809001107  | 
| Provider Name | Kateryna A Poole | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1144600925 PECOS PAC ID: 3072829712 Enrollment ID: I20180822000374  | 
| Provider Name | Jennifer Doucet Guidry | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1629554159 PECOS PAC ID: 8729338413 Enrollment ID: I20180829003728  | 
| Provider Name | Christopher Mesa | 
|---|---|
| Provider Type | Practitioner - Rheumatology | 
| Provider Identifiers | NPI Number: 1598150542 PECOS PAC ID: 2567719883 Enrollment ID: I20180918004008  | 
| Provider Name | Clayton J Alombro | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1225510191 PECOS PAC ID: 1557612256 Enrollment ID: I20180919001702  | 
| Provider Name | Jorge Alberto Morales | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1265829956 PECOS PAC ID: 9931452810 Enrollment ID: I20181023000555  | 
| Provider Name | Brittany Chatman Draper | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1669891651 PECOS PAC ID: 3971816208 Enrollment ID: I20181025000158  | 
| Provider Name | Nathan Taillac | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1861888992 PECOS PAC ID: 9133493455 Enrollment ID: I20181030001672  | 
| Provider Name | Manicia Shundreal Liddell | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1568963866 PECOS PAC ID: 3779829908 Enrollment ID: I20190109001905  | 
| Provider Name | Faheem Iqbal | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1902165475 PECOS PAC ID: 4981846805 Enrollment ID: I20190411001936  | 
| Provider Name | Stephanie Ann Launey | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1740744341 PECOS PAC ID: 5991048936 Enrollment ID: I20190515001710  | 
| Provider Name | Kristen H Hibbard | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1508329483 PECOS PAC ID: 5092048884 Enrollment ID: I20190611000409  | 
| Provider Name | David Neil Campbell | 
|---|---|
| Provider Type | Practitioner - Critical Care (intensivists) | 
| Provider Identifiers | NPI Number: 1134562432 PECOS PAC ID: 4981844750 Enrollment ID: I20190731001522  | 
| Provider Name | Riddhi S Banthia | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1588019343 PECOS PAC ID: 3375837685 Enrollment ID: I20190917000119  | 
| Provider Name | Loi Le | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1730543232 PECOS PAC ID: 5092009217 Enrollment ID: I20190918002310  | 
| Provider Name | Shomari Jamal Olden | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1356791131 PECOS PAC ID: 3274828975 Enrollment ID: I20191010001105  | 
| Provider Name | Haroon Iqbal | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1407309479 PECOS PAC ID: 5294013306 Enrollment ID: I20191022001809  | 
| Provider Name | Madhumati Gaddam Reddy | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1083063978 PECOS PAC ID: 1254628654 Enrollment ID: I20191116000080  | 
| Provider Name | Zachary Colin Hand | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1720441389 PECOS PAC ID: 4789921156 Enrollment ID: I20200221000727  | 
| Provider Name | Chastity L Boudreaux | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1790324655 PECOS PAC ID: 0143650473 Enrollment ID: I20200428001355  | 
| Provider Name | Priscilla Givens Becnel | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1679919971 PECOS PAC ID: 7719273150 Enrollment ID: I20200625000919  | 
| Provider Name | Justin Cutrer | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1720518764 PECOS PAC ID: 1052675899 Enrollment ID: I20200831000433  | 
| Provider Name | Andrew M Burke | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1760915631 PECOS PAC ID: 4981021912 Enrollment ID: I20200903003162  | 
| Provider Name | Jamie Jones | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1174056394 PECOS PAC ID: 2769750140 Enrollment ID: I20200903003719  | 
| Provider Name | Niraja Bhrugushastri Patel | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1780292987 PECOS PAC ID: 0840618799 Enrollment ID: I20200909003413  | 
| Provider Name | Ethan Alfred Rosenblatt | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1053766014 PECOS PAC ID: 8325467590 Enrollment ID: I20201007003179  | 
| Provider Name | Ndeke Nyirenda | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1326319088 PECOS PAC ID: 5799924098 Enrollment ID: I20201102001741  | 
| Provider Name | Rebecca Hentze Varnado | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1699373613 PECOS PAC ID: 8123439908 Enrollment ID: I20201130001898  | 
| Provider Name | Brittany Johnson | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1457952400 PECOS PAC ID: 4587077227 Enrollment ID: I20210119001992  | 
| Provider Name | Abby Heath Anderson | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1376134049 PECOS PAC ID: 6709293715 Enrollment ID: I20210318000409  | 
| Provider Name | Neelay B Patel | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1912494667 PECOS PAC ID: 2769732361 Enrollment ID: I20210712000076  | 
| Provider Name | Katy Schulthess | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1023691581 PECOS PAC ID: 0840692059 Enrollment ID: I20210712000367  | 
| Provider Name | Nipur Patel | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1710410865 PECOS PAC ID: 1850794256 Enrollment ID: I20210722002571  | 
| Provider Name | Degian Ghebermicael | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1780144642 PECOS PAC ID: 4284031691 Enrollment ID: I20210928003056  | 
| Provider Name | Louis S Strauss | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1669641155 PECOS PAC ID: 1557417490 Enrollment ID: I20211013000356  | 
| Provider Name | Ahmad Hallak | 
|---|---|
| Provider Type | Practitioner - Cardiovascular Disease (cardiology) | 
| Provider Identifiers | NPI Number: 1548765910 PECOS PAC ID: 4486905809 Enrollment ID: I20211022000256  | 
| Provider Name | Lisa Tran-laurent | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1548832587 PECOS PAC ID: 3870983042 Enrollment ID: I20211201002521  | 
| Provider Name | Drew M Newberry | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1689135626 PECOS PAC ID: 1052647203 Enrollment ID: I20211208000577  | 
| Provider Name | Rebecca Chair Muzika | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1396318978 PECOS PAC ID: 6204226111 Enrollment ID: I20211208003208  | 
| Provider Name | Benjamin Deaton | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1376803437 PECOS PAC ID: 3870872468 Enrollment ID: I20220422001609  | 
| Provider Name | John Gaudet | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1326543414 PECOS PAC ID: 0345596458 Enrollment ID: I20220804002714  | 
| Provider Name | Janki Yogesh Patel | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1750737342 PECOS PAC ID: 6305139056 Enrollment ID: I20220830004044  | 
| Provider Name | Lacey Miller | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1225770266 PECOS PAC ID: 2860877982 Enrollment ID: I20220909002198  | 
| Provider Name | Kantha Ratnam Kolla | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1255891586 PECOS PAC ID: 9032594908 Enrollment ID: I20220913001213  | 
| Provider Name | Omar Sallam | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1548821911 PECOS PAC ID: 7113259557 Enrollment ID: I20220914002527  | 
| Provider Name | Mary Bridges | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1164072591 PECOS PAC ID: 5799161295 Enrollment ID: I20221006002904  | 
| Provider Name | Shawn Tredinnick | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1194456541 PECOS PAC ID: 9436525599 Enrollment ID: I20221014002263  | 
| Provider Name | Kehinde Moses Ajayi | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1407343684 PECOS PAC ID: 7911392444 Enrollment ID: I20221208003279  | 
| Provider Name | Sarah Jayne Sternlieb | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1376997684 PECOS PAC ID: 8820381411 Enrollment ID: I20230306001434  | 
| Provider Name | Richard Durante | 
|---|---|
| Provider Type | Practitioner - Family Practice | 
| Provider Identifiers | NPI Number: 1508279795 PECOS PAC ID: 5496973653 Enrollment ID: I20230530002680  | 
| Provider Name | Jennifer Brunett | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1497454888 PECOS PAC ID: 6103285473 Enrollment ID: I20230705001040  | 
| Provider Name | Lisa Laraine South | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1275307472 PECOS PAC ID: 7012353725 Enrollment ID: I20240315001401  | 
| Provider Name | Kaytlin T Verret | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1477336725 PECOS PAC ID: 1254772122 Enrollment ID: I20240509000184  | 
| Provider Name | Mary A Gabriel | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1023692696 PECOS PAC ID: 7012311756 Enrollment ID: I20240603004108  | 
| Provider Name | Thu Anh Nguyen | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1104509314 PECOS PAC ID: 1658815378 Enrollment ID: I20240704000298  | 
| Provider Name | Syed R Hussain | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1487281721 PECOS PAC ID: 5597169102 Enrollment ID: I20240823003275  | 
| Provider Name | Mark Jude Gaudet | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1972333706 PECOS PAC ID: 2163956889 Enrollment ID: I20241116000415  | 
| Provider Name | Brenna Cook | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1598561821 PECOS PAC ID: 1759802416 Enrollment ID: I20250311000247  | 
| Provider Name | Mohamed Ibrahim Ayash | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1346689742 PECOS PAC ID: 5193011757 Enrollment ID: I20250320000431  | 
| Provider Name | Elizabeth Carol Bateman | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1710797964 PECOS PAC ID: 5294259750 Enrollment ID: I20250407002165  | 
| Provider Name | John William Nord | 
|---|---|
| Provider Type | Practitioner - Hospitalist | 
| Provider Identifiers | NPI Number: 1245402817 PECOS PAC ID: 9436331162 Enrollment ID: I20250408003952  | 
| Provider Name | Anthony Alonzo Aldrich | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1699418772 PECOS PAC ID: 7214466077 Enrollment ID: I20250515002805  | 
| Provider Name | Ruona Ebiai | 
|---|---|
| Provider Type | Practitioner - Internal Medicine | 
| Provider Identifiers | NPI Number: 1184366205 PECOS PAC ID: 2567971799 Enrollment ID: I20250530001664  | 
Charlie H Bridges Md, Facs Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 7777 Hennessy Blvd Ste 608, Baton Rouge, LA 70808 Phone: 225-767-0394 Fax: 225-767-3904  | |
Venus/neuropathy Treatment Centers Of La,llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3233 S Sherwood Forest Blvd, Suite110, Baton Rouge, LA 70816 Phone: 225-636-5184 Fax: 225-636-5185  | |
Central Community School District Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 13421 Hooper Rd, Baton Rouge, LA 70818 Phone: 225-262-1919  | |
Deekay Medical Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3923 Convention St, Baton Rouge, LA 70806 Phone: 225-381-6478  | |
Total Family Healthcare, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 4336 North Blvd, Suite 103, Baton Rouge, LA 70806 Phone: 225-383-3187 Fax: 225-383-3190  | |
3c&l Healthcare Llc Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 4720 Bluebonnet Blvd Ste B, Baton Rouge, LA 70809 Phone: 225-256-7219  | |
Comprehensive Healthcare Of La, Llc. Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 3535 Riley St, Baton Rouge, LA 70805 Phone: 225-931-4887  |