Individual provider Active NPI

Ebenezer S. Bediako, MD

  • Pediatrics Physician
  • Lafayette, LA
National Provider Identifier
1073731493
Registry record updated Dec 22, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
202914 Issued in LA
Practice address
4600 Ambassador Caffery Pkwy
Lafayette, LA 70508-6902
Phone
(337) 470-5500
Fax
(337) 521-9166
NPI assigned
Apr 23, 2007
Last updated
Dec 22, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2025

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

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 202914 LA Primary
Pediatrics Physician 208000000X 01063471A IN
Pediatric Critical Care Medicine Physician 2080P0203X 202914 LA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 202914 LA
Hospitalist Physician 208M00000X N1547 TX

Addresses

Primary practice location

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508-6902

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (337) 470-2605

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, TX2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20090826000155 LA Practitioner - Pediatric Medicine 4688775562 Reassigns benefits to 2 organizations
I20251220000806 TX Practitioner - Pediatric MedicinePractitioner - Hospitalist 4688775562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Pediatric MedicineAlso: Hospitalist
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

202 Summer Morning CT
Lafayette, LA 70508-7216

3601 4TH St
Lubbock, TX 79430-0001

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
01063471AINMDPediatrics Physician
202914LAMDPediatric Emergency Medicine (Pediatrics) Physician
N1547TXMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Tech University Health Sciences Center Lubbock CurrentSince Dec 1, 2025 Accepting new patients
Lourdes Physician Group LLC CurrentSince Sep 1, 2024 Accepting new patients
Coolidge Emergency Group LLC CurrentSince Mar 11, 2022 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Pediatrics CurrentSince Dec 1, 2025 Accepting new patients
Texas Tech University Health Sciences Center Lubbock Past Accepting new patients
Methodist Children's Hospital Past Accepting new patients
Our Lady of Lourdes Regional Medical Center, Inc Past Accepting new patients

Locations

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

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

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 371-3135

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

3502 9th St
Ste 130
Lubbock, TX 79415
Phone (806) 743-1188

4015 22nd Pl
Lubbock, TX 79410
Phone (806) 725-0000

602 Indiana Ave
Lubbock, TX 79415
Phone (806) 743-2898

Interoperability endpoints

  • Direct secure messaging: ebediako1472641@direct.ochsner.org

Organizations & group practices 8

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": "1177286400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766361600000",
    "number": "1073731493",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "337-470-2605",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086902",
            "telephone_number": "337-470-5500",
            "fax_number": "337-521-9166"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BEDIAKO",
        "first_name": "EBENEZER",
        "middle_name": "S.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-23",
        "last_updated": "2025-12-22",
        "certification_date": "2025-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "202914",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "IN",
            "license": "01063471A",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "LA",
            "license": "202914",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "LA",
            "license": "202914",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "TX",
            "license": "N1547",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.