Indira Gautam, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

15134R Issued in LA

Practice address

327 Iberia St
Suite #3a
Youngsville, LA 70592-5738

Phone

(337) 857-3512

Fax

(337) 857-3513

NPI assigned

Feb 9, 2006

Last updated

Jun 17, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

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: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Family Practice

Education

JC Edwards School of Medicine, Marshall University, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Lafayette Health Ventures IncGroup PAC ID 9335043074, 299 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002
• Ochsner St Martin Hospital Hospital, Breaux Bridge, LA, CCN 191302
• Ochsner University Hospital and Clinics Hospital, Lafayette, LA, CCN 190006
• Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102
• Iberia Medical Center Hospital, New Iberia, LA, CCN 190054

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir4.healow.com/fhir/r4/DICFBD/Endpoint/DICFBD

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.

• Lafayette Health Ventures Inc

  dba dba Family Health Plaza

  • Family Medicine Physician
  • Lafayette, LA
  • NPI 1417986092
  Medicare reassignment Care Compare group NPD
• Indira Gautam MD a Professional Medical Corporation

  • Family Medicine Physician
  • Youngsville, LA
  • NPI 1235531989
  Authorized official Same address or phone
• Lafayette Health Ventures, Inc

  • Internal Medicine Physician
  • Lafayette, LA
  • NPI 1467687186
  NPD
• Cypress Health and Wellness LLC

  • Primary Care Nurse Practitioner
  • Youngsville, LA
  • NPI 1114681350
  NPD (past)

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

• Hospital Service District No 1 of Iberia Parish

  dba Iberia Medical Center

  • Rehabilitation Hospital Unit
  • New Iberia, LA
  • NPI 1992159925
  Care Compare affiliation
• Hospital Service District No. 1 of Iberia Parish

  dba Iberia Medical Center

  • General Acute Care Hospital
  • New Iberia, LA
  • NPI 1285601088
  Care Compare affiliation
• Lafayette General Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1275536799
  Care Compare affiliation
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  Care Compare affiliation
• St Martin Hospital, Inc.

  dba St Martin Hospital

  • Critical Access Hospital
  • Breaux Bridge, LA
  • NPI 1437482817
  Care Compare affiliation
• University Hospital & Clinics, Inc.

  dba Ochsner University Hospital & Clinics

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1306281126
  Care Compare affiliation

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

{
    "created_epoch": "1139443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402963200000",
    "number": "1043283005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "327 IBERIA ST",
            "address_2": "SUITE #3A",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705925738",
            "telephone_number": "337-857-3512",
            "fax_number": "337-857-3513"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "327 IBERIA ST",
            "address_2": "SUITE #3A",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705925738",
            "telephone_number": "337-857-3512",
            "fax_number": "337-857-3513"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTAM",
        "first_name": "INDIRA",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-02-09",
        "last_updated": "2014-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "15134R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1191167",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Laura Ann Frollo, PA-C
• Hazmin Funez
• Samantha M Fuselier
• Cherie Duhon Garrett, SSP, NCSP
• Katina F Gary
• Aleice Wilmore Gauthier, LMSW
• Jeanie Marie Gauthier
• Taylor Genest, LMT
• Rebecca Bloomer Gilley
• Luciana Girouard

• Family Medicine Physician in Youngsville, LA
• Providers in Youngsville, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2014; 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.