Individual provider Active NPI

Bradley Paul Chauvin, PA-C

  • Medical Physician Assistant
  • Houma, LA
National Provider Identifier
1073610044
Registry record updated Jan 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
A10260RX Issued in LA
Practice address
1340 Grand Caillou Rd
Houma, LA 70363-5558
Phone
(985) 262-4424
NPI assigned
Sep 20, 2006
Last updated
Jan 7, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X A10260RX LA Primary

Addresses

Primary practice location

1340 Grand Caillou Rd
Houma, LA 70363-5558

Mailing address

219 Joshua Reed Dr
Houma, LA 70360-8930
Phone (985) 209-2203

Other identifiers 1

IdentifierTypeStateIssuer
1626783MedicaidLA

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
I20090827000184 LA Practitioner - Physician Assistant 0941367346 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Delta Medical GroupGroup PAC ID 4688977549, 10 clinicians

Practice addresses (Care Compare)

1340 Grand Caillou Rd
Houma, LA 70363-5558
Phone (985) 262-4424

1505 Hwy 90 E
Morgan City, LA 70380-5374
Phone (985) 745-6000

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A10260RXLAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Louisiana Em-1 Medical Services, PC Past Accepting new patients
Bayou Parishes Emergency Physicians Past Accepting new patients

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1452124800000",
    "number": "1073610044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 JOSHUA REED DR",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703608930",
            "telephone_number": "985-209-2203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1340 GRAND CAILLOU RD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703635558",
            "telephone_number": "985-262-4424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAUVIN",
        "first_name": "BRADLEY",
        "middle_name": "PAUL",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-20",
        "last_updated": "2016-01-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "A10260RX",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1626783",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

Verify at the official NPI Registry.