Active NPI
James Kevin Modisette, M.D.
- Nephrology Physician
- Thibodaux, LA
National Provider Identifier
1063413995
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nephrology Physician
- License
- 22699
- Practice address
- 604 N. Acadia Rd.
Suite 405
Thibodaux, LA 70301 - Phone
- (985) 446-0871
- Fax
- (985) 446-0874
- NPI assigned
- Aug 2, 2005
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nephrology Physician | 207RN0300X | 22699 | LA | Primary |
Addresses
Primary practice location
604 N. Acadia Rd.
Suite 405
Thibodaux, LA 70301
Mailing address
604 N. Acadia Rd.
Suite 405
Thibodaux, LA 70301
Phone (985) 446-0871
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1492141 | Medicaid | LA | |
| 7814220 | Other | AETNA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nephrology
- Education
- Louisiana State University School of Medicine in New Orleans, 1996
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
604 N Acadia Rd
Suite 405
Thibodaux, LA 70301-4897
Phone (985) 446-0871
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kidney Center of South Louisiana, AMC | Nephrology | Current | Accepting new patients |
Locations
604 N Acadia Rd
Ste 405
Thibodaux, LA 70301
Phone (985) 446-0871
Interoperability endpoints
- james.modisette@kcosla.eclinicaldirectplus.com
- https://fhir4.healow.com/fhir/r4/EFEIBA
- https://fhir4.healow.com/fhir/r4/EFEIBA/Endpoint/EFEIBA
- jmodisette408171@direct.ochsner.org
Organizations & group practices 1
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.
-
- Nephrology Physician
- Thibodaux, LA
- NPI 1386858918
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Fresenius Kidney Care North Thibodaux
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Thibodaux, LA
- NPI 1740715093
Dialysis facility
-
dba Bayou Lafourche Artificial Kidney Center
- End-Stage Renal Disease (ESRD) Treatment Clinic/Center
- Thibodaux, LA
- NPI 1790897544
Dialysis facility
-
dba Lady of the Sea General Hospital
- Critical Access Hospital
- Cut Off, LA
- NPI 1407883341
-
dba Ochsner St. Anne General Hospital
- Critical Access Hospital
- Raceland, LA
- NPI 1396761805
-
dba Ochsner St. Mary
- General Acute Care Hospital
- Morgan City, LA
- NPI 1205482023
-
dba Terrebonne General Medical Center
- General Acute Care Hospital
- Houma, LA
- NPI 1518924109
-
- General Acute Care Hospital
- Thibodaux, LA
- NPI 1902465065
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1122940800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1253836800000",
"number": "1063413995",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "604 N. ACADIA RD.",
"address_2": "SUITE 405",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "70301",
"telephone_number": "985-446-0871",
"fax_number": "985-446-0874"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "604 N. ACADIA RD.",
"address_2": "SUITE 405",
"city": "THIBODAUX",
"state": "LA",
"postal_code": "70301",
"telephone_number": "985-446-0871",
"fax_number": "985-446-0874"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MODISETTE",
"first_name": "JAMES",
"middle_name": "KEVIN",
"name_prefix": "Mr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-02",
"last_updated": "2009-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "207RN0300X",
"taxonomy_group": "",
"desc": "Internal Medicine, Nephrology",
"state": "LA",
"license": "22699",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1492141",
"state": "LA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AETNA",
"identifier": "7814220",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Thibodaux, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2009; 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.