| Pediatric Group Of Acadiana, Llc | |
| 
					12713 Water Way Maurepas LA 70449-1200  | |
| (225) 698-0211 | |
| (225) 424-6009 | 
| Full Name | Pediatric Group Of Acadiana, Llc | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 12713 Water Way, Maurepas, Louisiana | 
| Authorized Official Name and Position | Antoinette Rabenaldt (CREDENTIALING COORDINATOR) | 
| Authorized Official Contact | 3373302576 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Pediatric Group Of Acadiana, Llc 302 Hacker St New Iberia LA 70560-4508 Ph: (337) 330-2576  | Pediatric Group Of Acadiana, Llc 12713 Water Way Maurepas LA 70449-1200 Ph: (225) 698-0211  | 
| NPI Number | 1588138903 | 
|---|---|
| Provider Enumeration Date | 01/18/2019 | 
| Last Update Date | 12/03/2024 | 
| Medicare PECOS PAC ID | 2466476023 | 
|---|---|
| Medicare Enrollment ID | O20190222001392 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1588138903 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QR1300X | Clinic/center - Rural Health | (* (Not Available)) | Primary | 
Our Lady Of The Lake Physician Group, Llc Primary Care Clinic Medicare: Medicare Enrolled Practice Location: 18740 Highway 22, Maurepas, LA 70449 Phone: 225-698-3435 Fax: 225-698-6446  | |
Rkm At Maurepas School Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 23923 Highway 22, Maurepas, LA 70449 Phone: 225-683-5292 Fax: 225-683-1310  |