NPIMap

Individual provider Active NPI

Jason Peary Bridges

  • Urology Physician
  • Baton Rouge, LA
National Provider Identifier
1003129651
Registry record updated Feb 5, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD.208016 Issued in LA
Practice address
7777 Hennessy Blvd Ste 608
Baton Rouge, LA 70808-4366
Phone
(225) 767-0394
Fax
(225) 767-3904
NPI assigned
Jul 23, 2010
Last updated
Feb 5, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 5, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD.208016 LA Primary

Addresses

Primary practice location

7777 Hennessy Blvd Ste 608
Baton Rouge, LA 70808-4366

Mailing address

7777 Hennessy Blvd Ste 608
Baton Rouge, LA 70808-4366
Phone (225) 767-0394

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150819008922 LA Practitioner - Urology 5597070540 Reassigns benefits to 1 organization
Practice locations: Baton Rouge, LA

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
University of Mississippi School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1125 W Hwy 30
Gonzales, LA 70737-5004
Phone (225) 621-2975

1710 N Airline Hwy
Gonzales, LA 70737-2127
Phone (225) 765-5500

7777 Hennessy Blvd
Baton Rouge, LA 70808-4363

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection11

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD.208016LAMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Jun 13, 2016 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Jun 13, 2016 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

7777 Hennessy Blvd
Ste 302
Baton Rouge, LA 70808
Phone (225) 374-0500

1014 Saint Clair Blvd
Ste 3000
Gonzales, LA 70737
Phone (225) 743-2444

1710 N Airline Hwy
Gonzales, LA 70737
Phone (225) 644-6547

Networks

  • MS PPO
  • MS PPO C-SNP
  • TX HMO D-SNP
  • LA PPO C-SNP
  • MS PPO D-SNP
  • TX HMO

Organizations & group practices 3

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

Hospital & facility affiliations 7

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

NPI Registry JSON

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

{
    "created_epoch": "1279843200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454630400000",
    "number": "1003129651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 608",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084366",
            "telephone_number": "225-767-0394",
            "fax_number": "225-767-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 608",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084366",
            "telephone_number": "225-767-0394",
            "fax_number": "225-767-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIDGES",
        "first_name": "JASON",
        "middle_name": "PEARY",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2010-07-23",
        "last_updated": "2016-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "LA",
            "license": "MD.208016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.