Individual provider Active NPI

Jason R Comeaux, PA-C

  • Physician Assistant
  • Lafayette, LA
National Provider Identifier
1104825371
Registry record updated Mar 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA10608RX Issued in LA
Practice address
4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone
(337) 470-2605
Fax
(337) 470-4595
NPI assigned
Jul 19, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA10608RX LA Primary

Addresses

Primary practice location

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917

Mailing address

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

Other practice location 1

935 Camellia Blvd
Ste 103
Lafayette, LA 70508-7084
Phone (337) 534-4356

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
I20040818000039 LA Practitioner - Physician Assistant 9133192149 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lourdes Physician Group LLCGroup PAC ID 7214177757, 157 clinicians

Practice addresses (Care Compare)

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2990

Hospital & facility affiliations

  • Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA10608RXLAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Prevail Imaging, LLC Past Accepting new patients

Organizations & group practices 2

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 1

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": "1121731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1741305600000",
    "number": "1104825371",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4801 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705086917",
            "telephone_number": "337-470-2605",
            "fax_number": "337-470-4595"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "935 Camellia Blvd",
            "address_2": "Ste 103",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705087084",
            "country_code": "US",
            "telephone_number": "337-534-4356",
            "fax_number": "337-534-4357",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "COMEAUX",
        "first_name": "JASON",
        "middle_name": "R",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-19",
        "last_updated": "2025-03-07",
        "certification_date": "2025-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA10608RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.