Individual provider Active NPI

Vasanth K Nalam, MD

  • Pediatrics Physician
  • Lafayette, LA
National Provider Identifier
1093779654
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
04740R Issued in LA
Practice address
4630 Ambassador Caffery Pkwy Ste 308
Lafayette, LA 70508-6950
Phone
(337) 470-3860
Fax
(337) 470-3858
NPI assigned
Apr 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Adolescent Medicine Physician 2080A0000X 04740R LA
Pediatrics Physician 208000000X 04740R LA Primary

Addresses

Primary practice location

4630 Ambassador Caffery Pkwy Ste 308
Lafayette, LA 70508-6950

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0011

Other identifiers 1

IdentifierTypeStateIssuer
1198412MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address vnalam288786@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

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
I20200124001924 LA Practitioner - Pediatric Medicine 3274968052 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes Physician Group LLC CurrentSince Jan 12, 2020 Accepting new patients

Locations

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

4704 Ambassador Caffery Pkwy
Ste 301
Lafayette, LA 70508
Phone (337) 443-6870

4704 Ambassador Caffery Pkwy
Fl 3
Lafayette, LA 70508
Phone (337) 470-5920

4630 Ambassador Caffery Pkwy
Ste 308
Lafayette, LA 70508
Phone (337) 289-5277

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

4540 Ambassador Caffery Pkwy
Ste B150
Lafayette, LA 70508
Phone (337) 500-1752

Interoperability endpoints

  • Direct secure messaging: vnalam288786@direct.casso.us.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1093779654",
    "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": "225-526-0011",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4630 AMBASSADOR CAFFERY PKWY STE 308",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086950",
            "telephone_number": "337-470-3860",
            "fax_number": "337-470-3858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NALAM",
        "first_name": "VASANTH",
        "middle_name": "K",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080A0000X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "LA",
            "license": "04740R",
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "04740R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1198412",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "vnalam288786@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "vnalam288786@direct.casso.us.com",
            "address_1": "4704 Ambassador Caffery Pkwy Fl 3",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705086908",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "4704 Ambassador Caffery Pkwy Fl 3",
            "city": "Lafayette",
            "state": "LA",
            "country_code": "US",
            "postal_code": "705086908",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.