Gi Diagnostic Center

Primary specialty

Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X

License

130 Issued in LA

Legal business name

GI DIAGNOSTIC CENTER

Practice address

1100 Andre St
Ste 300
New Iberia, LA 70563-2159

Phone

(337) 365-6591

Fax

(337) 364-6094

NPI assigned

Feb 23, 2006

Organization subpart

No

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

Authorized official

Name

Luis E Alvarez, M.D.

Title

Medical Director

Phone

(337) 365-6591

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Enrollment records 1

Listed as

Gi Diagnostic Center LLCCCN 19C0001093

Medicare certification status

ActiveFrom the Provider of Services file

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

{
    "created_epoch": "1140652800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093781601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1100 ANDRE ST",
            "address_2": "STE 300",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632159",
            "telephone_number": "337-365-6591",
            "fax_number": "337-364-6094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 ANDRE ST",
            "address_2": "STE 300",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705632159",
            "telephone_number": "337-365-6591",
            "fax_number": "337-364-6094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GI DIAGNOSTIC CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-23",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ALVAREZ",
        "authorized_official_first_name": "LUIS",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "337-365-6591",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "LA",
            "license": "130",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1465844",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Vanessa Glaude

• Ambulatory Surgical Clinic/Center in New Iberia, LA
• Providers in New Iberia, LA by specialty
• Ambulatory Surgical Clinic/Center in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.