Individual provider Active NPI

Kerry Thomas Thibodeaux, MD FACS

  • Surgery Physician
  • Opelousas, LA
National Provider Identifier
1093774192
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
019158 Issued in LA
Practice address
1270 Attakapas Dr
Ste 202
Opelousas, LA 70570-6549
Phone
(337) 948-4362
Fax
(337) 942-6523
NPI assigned
Mar 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 019158 LA Primary

Addresses

Primary practice location

1270 Attakapas Dr
Ste 202
Opelousas, LA 70570-6549

Mailing address

1270 Attakapas Dr
Ste 202
Opelousas, LA 70570-6549
Phone (337) 948-4362

Other identifiers 1

IdentifierTypeStateIssuer
1374105MedicaidLA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050223000122 LA Practitioner - General SurgeryPractitioner - Other (Physician)Practitioner - Thoracic SurgeryPractitioner - Vascular Surgery 7416915541 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
General SurgeryAlso: Thoracic Surgery, Vascular Surgery
Education
Louisiana State University School of Medicine in New Orleans, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1233 Wayne Gilmore Circle
Suite 250B
Opelousas, LA 70570-6404
Phone (337) 948-4362

Hospital & facility affiliations

  • St Landry Homecare Home health agency, Opelousas, LA, CCN 197136
  • Beauregard Home Health Home health agency, Deridder, LA, CCN 197183
  • Opelousas General Health System Hospital, Opelousas, LA, CCN 190017
  • Beauregard Memorial Hospital Hospital, Deridder, LA, CCN 190050
  • Ochsner St Martin Hospital Hospital, Breaux Bridge, LA, CCN 191302
  • Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy1-10
Upper gastrointestinal (GI) endoscopy for acid reflux1-10
Removal of tissue51
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
019158LAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
SKP Wound Care of Louisiana LLC CurrentSince Jul 1, 2023 Accepting new patients
St Martin Hospital, Inc. CurrentSince Apr 1, 2018 Accepting new patients
Kerry T. Thibodeaux MD Apmc Surgery CurrentSince Apr 1, 2006 Accepting new patients
St. Martin Hospital, Inc. CurrentSince Apr 1, 2018 Accepting new patients
St. Martin Hospital, Inc. Current Accepting new patients
Opelousas General Hospital Authority PastSince Jul 1, 2019 Accepting new patients

Locations

1555 Gary Dr
#A
Breaux Bridge, LA 70517
Phone (337) 909-2474

210 Champagne Blvd
Breaux Bridge, LA 70517
Phone (337) 332-2178

576 N Avenue G
Ste B
Crowley, LA 70526
Phone (337) 581-2612

539 E Prudhomme St
Opelousas, LA 70570
Phone (337) 943-7128

1233 Wayne Gilmore Cir
Ste 250B
Opelousas, LA 70570
Phone (337) 407-1955

Organizations & group practices 6

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.

Hospital & facility affiliations 6

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": "1142812800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1093774192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 ATTAKAPAS DR",
            "address_2": "STE 202",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705706549",
            "telephone_number": "337-948-4362",
            "fax_number": "337-942-6523"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1270 ATTAKAPAS DR",
            "address_2": "STE 202",
            "city": "OPELOUSAS",
            "state": "LA",
            "postal_code": "705706549",
            "telephone_number": "337-948-4362",
            "fax_number": "337-942-6523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIBODEAUX",
        "first_name": "KERRY",
        "middle_name": "THOMAS",
        "name_prefix": "Dr.",
        "credential": "MD FACS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-03-20",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "019158",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1374105",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Opelousas, LA

Sources for this page

Verify at the official NPI Registry.