Individual provider Active NPI

Brennan Joseph Thibodeaux, PA

  • Physician Assistant
  • Thibodaux, LA
National Provider Identifier
1073221917
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
334149 Issued in LA
Practice address
726 N Acadia Rd Ste 1000
Thibodaux, LA 70301-5051
Phone
(985) 625-2200
NPI assigned
Nov 9, 2022
Last updated
Apr 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 334149 LA Primary

Addresses

Primary practice location

726 N Acadia Rd Ste 1000
Thibodaux, LA 70301-5051

Mailing address

PO Box 28
Thibodaux, LA 70302-0028
Phone (985) 492-1203

Other practice location 1

104 Medical Center Dr
Slidell, LA 70461-5575
Phone (985) 646-5550

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221214003309 LA Practitioner - Physician Assistant 9931578853 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Louisiana State University School of Medicine in Shreveport, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

100 Medical Ctr Dr
Slidell, LA 70461-5520
Phone (985) 646-5055

1001 Gause Blvd
Slidell, LA 70458-2939
Phone (985) 646-5970

104 Acadia Park Dr
Raceland, LA 70394-2618
Phone (985) 537-3211

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

1516 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3470

71380 Hwy 21
Covington, LA 70433-7245
Phone (985) 661-3534

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Apr 21, 2025 Accepting new patients
Hospital Service District No. 1 of the Parish of St. Mary CurrentSince Jun 1, 2023 Accepting new patients
Orthopaedic Sports Specialists of Louisiana LLC CurrentSince Nov 15, 2022 Accepting new patients
Hospital Service District No. 1 of the Parish of St. Mary CurrentSince Jun 1, 2023 Accepting new patients
Ochsner Clinic LLC CurrentSince Apr 21, 2025 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

1029 Northwest Blvd
Franklin, LA 70538
Phone (337) 366-6004

1105 Northwest Blvd
Franklin, LA 70538
Phone (337) 828-9729

200 Medical Dr
Ste C
Franklin, LA 70538
Phone (337) 907-6102

180 Corporate Dr
Houma, LA 70360
Phone (985) 853-1390

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

726 N Acadia Rd
Ste 1000
Thibodaux, LA 70301

Interoperability endpoints

  • Direct secure messaging: bthibodeaux2418614@direct.ochsner.org

Organizations & group practices 7

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 3

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": "1667952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1073221917",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 28",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703020028",
            "telephone_number": "985-492-1203",
            "fax_number": "985-492-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "726 N ACADIA RD STE 1000",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015051",
            "telephone_number": "985-625-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Medical Center Dr",
            "address_purpose": "LOCATION",
            "city": "Slidell",
            "state": "LA",
            "postal_code": "704615575",
            "country_code": "US",
            "telephone_number": "985-646-5550",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "BRENNAN",
        "middle_name": "JOSEPH",
        "name_prefix": "Mr.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-11-09",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "334149",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.