NPIMap

Individual provider Active NPI

Benjamin Thomas Degatur, M.D.

  • Family Medicine Physician
  • Breaux Bridge, LA
National Provider Identifier
1013158088
Registry record updated Jun 28, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.205020 Issued in LA
Practice address
206 Champagne Blvd
Suite a
Breaux Bridge, LA 70517-3734
Phone
(337) 332-3500
Fax
(337) 332-3200
NPI assigned
Mar 20, 2009
Last updated
Jun 28, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Family Medicine Physician 207Q00000X MD.205020 LA Primary

Addresses

Primary practice location

206 Champagne Blvd
Suite a
Breaux Bridge, LA 70517-3734

Mailing address

PO Box 335
Breaux Bridge, LA 70517-0335
Phone (337) 654-4501

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
I20120710000396 LA Practitioner - General PracticePractitioner - Family Practice 3375708746 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
General PracticeAlso: Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Warren J. Degatur, Jr. MD IncGroup PAC ID 4385707108, 2 clinicians

Practice addresses (Care Compare)

1525 E Bridge St
Breaux Bridge, LA 70517-3734
Phone (337) 442-1131

206 Champagne Blvd
Breaux Bridge, LA 70517-3734
Phone (337) 332-3500

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Warren J. Degatur, Jr. MD Inc Family Medicine CurrentSince Jul 1, 2012 Accepting new patients
St. Agnes Healthcare & Rehab Center,Inc. Past Accepting new patients

Locations

206 Champagne Blvd
Breaux Bridge, LA 70517
Phone (337) 332-3500

206 Champagne Blvd
Ste A
Breaux Bridge, LA 70517
Phone (337) 332-3500

606 Latiolais Dr
Breaux Bridge, LA 70517
Phone (337) 332-4808

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/2cb3d6db-a361-49b3-a3c3-68fe3216159f/

Organizations & group practices 2

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 9

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": "1237507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340841600000",
    "number": "1013158088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 335",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705170335",
            "telephone_number": "337-654-4501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CHAMPAGNE BLVD",
            "address_2": "SUITE A",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705173734",
            "telephone_number": "337-332-3500",
            "fax_number": "337-332-3200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGATUR",
        "first_name": "BENJAMIN",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-03-20",
        "last_updated": "2012-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.205020",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Breaux Bridge, LA

Sources for this page

Verify at the official NPI Registry.