Tate James Perque, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA200387 Issued in LA

Practice address

1453 E Bert Kouns Industrial Loop Ste 318
Shreveport, LA 71105-6810

Phone

(318) 681-1968

Fax

(318) 681-1969

NPI assigned

Sep 24, 2010

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Christus Trinity Clinic TexasGroup PAC ID 3072426741, 1,540 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Christus Shreveport-Bossier Health System Hospital, Shreveport, LA, CCN 190041
• Willis Knighton Medical Center Hospital, Shreveport, LA, CCN 190111

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/996/brand/1/csg/213/fhir/r4
• Direct secure messaging: tperque239770@christushealth.direct-ci.net

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Christus Trinity Clinic Texas

  • Family Medicine Physician
  • Tyler, TX
  • NPI 1285684225

  LA

  Medicare reassignment Care Compare group NPD
• C H Wilkinson Physician Network

  • Family Medicine Physician
  • Irving, TX
  • NPI 1457382947

  LA, Physician Assistant

  Medicare reassignment NPD
• WK Red River Cardiovascular Surgeons

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Shreveport, LA
  • NPI 1639314271
  Medicare reassignment
• C H Wilkinson Physician Network

  • Orthopaedic Surgery Physician
  • Corpus Christi, TX
  • NPI 1750826095
  NPD
• Christus Trinity Clinic Texas

  • Rural Health Clinic/Center
  • Winnsboro, TX
  • NPI 1801673165
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Christus Health Northern Louisiana

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1417950106
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Bossier City, LA
  • NPI 1003968579
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1124170691
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1275685539
  Care Compare affiliation
• Willis Knighton Medical Center, Inc.

  • General Acute Care Hospital
  • Shreveport, LA
  • NPI 1568461572
  Care Compare affiliation

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1285286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595894400000",
    "number": "1003125055",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2900 SAINT MICHAEL DR STE 401",
            "city": "TEXARKANA",
            "state": "TX",
            "postal_code": "755035211",
            "telephone_number": "903-614-5368",
            "fax_number": "903-614-5343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 E BERT KOUNS INDUSTRIAL LOOP STE 318",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711056810",
            "telephone_number": "318-681-1968",
            "fax_number": "318-681-1969"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2751 Albert L Bicknell Dr",
            "address_2": "Suite 5C",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711033920",
            "country_code": "US",
            "telephone_number": "318-227-9777",
            "fax_number": "318-459-1188",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3315 Centenary Blvd",
            "address_purpose": "LOCATION",
            "city": "Shreveport",
            "state": "LA",
            "postal_code": "711044503",
            "country_code": "US",
            "telephone_number": "318-230-3601",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PERQUE",
        "first_name": "TATE",
        "middle_name": "JAMES",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-09-24",
        "last_updated": "2020-07-28",
        "certification_date": "2020-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "LA",
            "license": "PA.200387",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA200387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2125362",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Birdwell Perkins, NP
• Nathaniel Perkins, DPT
• Rekisha Roshela Perkins
• Kassady Alexis Perkinson, DO
• Paul E Perkowski, M.D.
• Christopher Paul Perrero, CRNA
• Amelia Perry
• Charvez L Perry
• Dameon Decaven Perry
• Doris Perry

• Physician Assistant in Shreveport, LA
• Providers in Shreveport, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.