Individual provider Active NPI

Juan R Paredes, MD

  • Surgery Physician
  • Lafayette, LA
National Provider Identifier
1144326901
Registry record updated Aug 16, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
L12775R Issued in LA
Practice address
4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone
(337) 261-1171
Fax
(337) 261-1173
NPI assigned
Sep 16, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 16, 2023

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 L12775R LA Primary

Addresses

Primary practice location

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917

Mailing address

PO Box 52483
Lafayette, LA 70505-2483
Phone (337) 261-1171

Other identifiers 1

IdentifierTypeStateIssuer
1543306MedicaidLA

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
I20100330001325 LA Practitioner - General Surgery 8628104544 Reassigns benefits to 2 organizations
Practice locations: Lafayette, LA

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Other, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 261-1171

501 W Saint Mary Blvd
Suite 302
Lafayette, LA 70506-4699

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue531

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
L12775RLAMDSurgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Surgical Hospital Management System LLC Surgery CurrentSince Jul 1, 2013 Accepting new patients
General Surgery Services Apmc Surgery CurrentSince Nov 1, 2020 Accepting new patients
Acadiana Renal Physicians AMC Past Accepting new patients
Physicians Unity PastSince Dec 1, 2022 Accepting new patients

Locations

501 W Saint Mary Blvd
Ste 302
Lafayette, LA 70506
Phone (337) 261-1171

1000 W Pinhook Rd
Ste 310
Lafayette, LA 70503
Phone (337) 233-9900

4801 Ambassador Caffery Pkwy
#P
Lafayette, LA 70508

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

Organizations & group practices 4

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": "1158364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692144000000",
    "number": "1144326901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52483",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705052483",
            "telephone_number": "337-261-1171",
            "fax_number": "337-261-1173"
        },
        {
            "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": "337-261-1171",
            "fax_number": "337-261-1173"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PAREDES",
        "first_name": "JUAN",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-16",
        "last_updated": "2023-08-16",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "L12775R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1543306",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.