Individual provider Active NPI

Lance Fogleman

  • Emergency Medicine Physician
  • Lafayette, LA
National Provider Identifier
1033476379
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
MD207073 Issued in LA
Practice address
1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone
(337) 501-3698
NPI assigned
Apr 11, 2012
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X MD207073 LA Primary

Addresses

Primary practice location

1214 Coolidge Blvd
Lafayette, LA 70503-2621

Mailing address

517 E Demanade Dr
Lafayette, LA 70503-2551
Phone (337) 501-3698

Medicare participation

Medicare enrollment files
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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150821013720 LA Practitioner - Emergency Medicine 4284949082 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in Shreveport, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coolidge Emergency Group LLCGroup PAC ID 4880846427, 25 clinicians

Practice addresses (Care Compare)

1214 Coolidge Blvd
Lafayette, LA 70503-2696
Phone (337) 289-7991

Hospital & facility affiliations

  • Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002

Merit-based Incentive Payment System (MIPS)

Final score
96.73 of 100Reported as group
Quality
84.95
Improvement activities
40
Cost
85.77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD207073LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ambassador Emergency Group LLC Emergency Medicine CurrentSince Jan 3, 2016 Accepting new patients
Crowley Emergency Group LLC Emergency Medicine CurrentSince Jun 20, 2015 Accepting new patients
Coolidge Emergency Group LLC Emergency Medicine CurrentSince Jun 20, 2015 Accepting new patients
Acadiana Acute Care Associates, LLC Emergency Medicine CurrentSince Feb 15, 2020 Accepting new patients

Locations

1305 E Highway 90
Crowley, LA 70526
Phone (337) 783-3222

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

2810 Ambassador Caffery Pkwy
Lafayette, LA 70506
Phone (337) 593-5423

Interoperability endpoints

  • Direct secure messaging: lfogleman1443536@direct.ochsner.org

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1334102400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1033476379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 E DEMANADE DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032551",
            "telephone_number": "337-501-3698"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 COOLIDGE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032621",
            "telephone_number": "337-501-3698"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOGLEMAN",
        "first_name": "LANCE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-04-11",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "MD207073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.