Jibran Elias Atwi, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

10447R Issued in LA

Practice address

401 Youngsville Hwy
Suite 100
Lafayette, LA 70508-5173

Phone

(337) 330-0031

Fax

(337) 330-0059

NPI assigned

Aug 3, 2005

Last updated

Nov 5, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Pediatric Medicine

Education

Other, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Pediatric Group of Acadiana, LLCGroup PAC ID 2466476023, 14 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

All facility ownership & control disclosures 7

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 7

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Pediatric Group of Acadiana LLC

  dba Pediatric Group of Acadiana & Family Clinic

  • Rural Health Clinic/Center
  • Erath, LA
  • NPI 1073973533

  5% Or Greater Direct Ownership Interest, Corporate Officer

  CMS ownership
• Pediatric Group of Acadiana LLC

  dba Pediatric Group of Acadiana & Church Point Clinic

  • Rural Health Clinic/Center
  • Church Point, LA
  • NPI 1619471463

  5% Or Greater Direct Ownership Interest, Corporate Officer

  CMS ownership
• Pediatric Group of Acadiana LLC

  dba Kids Clinic and Adult Wellness of Crowley

  • Rural Health Clinic/Center
  • Crowley, LA
  • NPI 1679126510

  5% Or Greater Direct Ownership Interest, Corporate Officer

  CMS ownership
• Pediatric Group of Acadiana LLC

  dba Kaplan Family Care Clinic

  • Rural Health Clinic/Center
  • Kaplan, LA
  • NPI 1922619238

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Pediatric Group of Acadiana, LLC

  dba Oxbow Family Practice

  • Rural Health Clinic/Center
  • New Roads, LA
  • NPI 1477027894

  5% Or Greater Direct Ownership Interest, Corporate Officer

  CMS ownership
• Pediatric Group of Acadiana, LLC

  dba Waterway Pediatrics

  • Rural Health Clinic/Center
  • Maurepas, LA
  • NPI 1588138903

  5% Or Greater Direct Ownership Interest, Corporate Officer

  CMS ownership
• Pediatric Group of Acadiana, LLC

  dba St. Martinville Maternal-Child Clinic

  • Rural Health Clinic/Center
  • Saint Martinville, LA
  • NPI 1922283225

  5% Or Greater Direct Ownership Interest

  CMS ownership

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Pediatric Group of Acadiana, LLC

  • Specialist
  • Lafayette, LA
  • NPI 1265499628
  Medicare reassignment Care Compare group NPD
• Pediatric Group of Acadiana LLC

  dba Kaplan Family Care Clinic

  • Rural Health Clinic/Center
  • Kaplan, LA
  • NPI 1922619238
  NPD
• Lafayette General Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1275536799
  NPD (past)
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  NPD (past)
• Pediatric Group of Acadiana, LLC

  dba Waterway Pediatrics

  • Rural Health Clinic/Center
  • Maurepas, LA
  • NPI 1588138903
  NPD (past)

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636070400000",
    "number": "1154322923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2308 E MAIN ST",
            "address_2": "SUITE G",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705604041",
            "telephone_number": "337-367-2001",
            "fax_number": "337-365-3050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 YOUNGSVILLE HWY",
            "address_2": "SUITE 100",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085173",
            "telephone_number": "337-330-0031",
            "fax_number": "337-330-0059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATWI",
        "first_name": "JIBRAN",
        "middle_name": "ELIAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2021-11-05",
        "certification_date": "2021-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "LA",
            "license": "10447R",
            "primary": true
        },
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "10447R",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1988791",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Assure
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• Joseph Andrew Atkins, O.D.
• William Christopher Atkinson, PA-C
• Andrew D Aubin, MD
• Tiana Aubrey
• Victoria Marie Aubrey
• Abby Aucoin, SLP
• Cheri Ann Aucoin

• Allergy & Immunology Physician in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Allergy & Immunology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• 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.