NPIMap

Individual provider Active NPI

Justin William Rudd, M.D.

  • Surgery Physician
  • Lake Charles, LA
National Provider Identifier
1174889794
Registry record updated Jun 29, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
309562 Issued in LA
Practice address
501 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone
(337) 312-8762
Fax
(337) 312-8044
NPI assigned
Apr 9, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2026

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 309562 LA Primary

Addresses

Primary practice location

501 Dr Michael Debakey Dr
Lake Charles, LA 70601

Mailing address

501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 312-8762

Other practice location 1

4150 Nelson Rd
Lake Charles, LA 70605-4148
Phone (504) 842-4000

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180717003138 LA Practitioner - General Surgery 5890091961 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Surgery
Education
Louisiana State University School of Medicine in Shreveport, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians
Imperial Health LLPGroup PAC ID 7719886779, 75 clinicians

Practice addresses (Care Compare)

4150 Nelson Rd
Suite G
Lake Charles, LA 70605-4133
Phone (337) 562-3761

501 Doctor Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 433-8400

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Colonoscopy18
Hernia repair - groin (open)1-10
Hernia repair (minimally invasive)13
Upper gastrointestinal (GI) endoscopy for acid reflux21
Removal of tissue13
Skin biopsy1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Health, LLP Surgery CurrentSince Aug 1, 2018 Accepting new patients
Imperial Health LLP CurrentSince Aug 1, 2018 Accepting new patients
Ochsner Clinic LLC Surgery Past Accepting new patients

Locations

501 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 312-8258

Interoperability endpoints

  • Direct secure messaging: justin.rudd@1288.direct.myezyaccess.com

Organizations & group practices 3

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 10

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": "1333929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1782691200000",
    "number": "1174889794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015724",
            "telephone_number": "337-312-8762",
            "fax_number": "337-312-8044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "70601",
            "telephone_number": "337-312-8762",
            "fax_number": "337-312-8044"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4150 Nelson Rd",
            "address_purpose": "LOCATION",
            "city": "Lake Charles",
            "state": "LA",
            "postal_code": "706054148",
            "country_code": "US",
            "telephone_number": "504-842-4000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RUDD",
        "first_name": "JUSTIN",
        "middle_name": "WILLIAM",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-09",
        "last_updated": "2026-06-29",
        "certification_date": "2026-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "LA",
            "license": "309562",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.