Paulla Danielle Brouillette, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

PA.200216 Issued in LA

Practice address

7777 Hennessy Blvd
Our Lady of the Lake Med CNTR -- ER Dept
Baton Rouge, LA 70808-4300

Phone

(888) 447-2450

Fax

(405) 341-9217

NPI assigned

Aug 6, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Spine Diagnostic Center of Baton Rouge, Inc a Professional Medical CorGroup PAC ID 8921995317, 11 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

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.

• Spine Diagnostic Center of Baton Rouge, Inc a Professional Medical Cor

  dba The Spine Diagnostic and Pain Treatment Center

  • Specialist
  • Baton Rouge, LA
  • NPI 1790712214
  Medicare reassignment Care Compare group
• Professional Emergency Physician Associates, LLC

  • Emergency Medicine Physician
  • Baton Rouge, LA
  • NPI 1992758247
  Medicare reassignment
• Immi, LLC

  • Primary Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1902549637
  NPD (past)
• Neuromedical Center

  • Specialist
  • Baton Rouge, LA
  • NPI 1740216399
  NPD (past)

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

{
    "created_epoch": "1217980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1013173343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "OUR LADY OF THE LAKE MED CNTR -- ER DEPT",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "888-447-2450",
            "fax_number": "405-341-9217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "OUR LADY OF THE LAKE MED CNTR -- ER DEPT",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "888-447-2450",
            "fax_number": "405-341-9217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUILLETTE",
        "first_name": "PAULLA",
        "middle_name": "DANIELLE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-06",
        "last_updated": "2026-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200216",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1319376",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD THRU PEPA",
            "identifier": "P00810364",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Steven H Brooksher, DDS
• Rebecca Broome
• Brothers Medical Transportation Inc
• Nicole N Broughton, BCBA, LBA
• Camryn Brouillette
• Tiffany Brouillette
• Aadilah Broussard
• Akeily Broussard
• Alison M Broussard
• Aryn P Broussard, PLPC

• Physician Assistant in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; 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.