Individual provider Active NPI

Michael J Prejean, MD PSYCHIATRIST

  • Psychiatry Physician
  • Mamou, LA
National Provider Identifier
1215087887
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
LA11703 Issued in LA
Practice address
1610 7TH St
Mamou, LA 70554
Phone
(337) 468-0111
NPI assigned
Jan 12, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X LA11703 LA Primary

Addresses

Primary practice location

1610 7TH St
Mamou, LA 70554

Mailing address

PO Box 12698
Alexandria, LA 71315
Phone (318) 627-6280

Other identifiers 1

IdentifierTypeStateIssuer
1133931MedicaidLA

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
I20050308001057 LA Practitioner - Psychiatry 0042264574 Reassigns benefits to 2 organizations
Practice locations: Breaux Bridge, LA; Duson, LA; Lafayette, LA; Rayne, LA; Sunset, LA

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 1971
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

2021 Crowley Rayne Hwy
Rayne, LA 70578-4027
Phone (337) 788-0091

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
11703LAMDClinical Social Worker
LA11703LAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mica McDaniel FNP-C, LLC Current Accepting new patients
Northlake Physicians Group Psychiatry CurrentSince Oct 22, 2024 Accepting new patients
Abbeville General Hospital CurrentSince May 1, 2020 Accepting new patients
Abbeville General Hospital CurrentSince May 1, 2020 Accepting new patients
Post Trauma Institute of Louisiana Past Accepting new patients
Phoenix Behavioral Hospital of Eunice, LLC PastSince Apr 1, 2008 Accepting new patients
Mercy Behavioral Hospital LLC Past Accepting new patients
Post Trauma Institute of Louisiana Past Accepting new patients
Greg M. Savoy MD a.P.M.C. Past Accepting new patients
Hospital Service District #2 of Lasalle Parish Past Accepting new patients

Locations

118 N Hospital Dr
Abbeville, LA 70510
Phone (337) 893-5466

23515 Highway 190
Mandeville, LA 70448
Phone (985) 624-4100

23699 Quail Ln
Mandeville, LA 70448
Phone (985) 334-4040

Organizations & group practices 10

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.

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": "1168560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215087887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 12698",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "71315",
            "telephone_number": "318-627-6280",
            "fax_number": "318-627-6280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 7TH ST",
            "city": "MAMOU",
            "state": "LA",
            "postal_code": "70554",
            "telephone_number": "337-468-0111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PREJEAN",
        "first_name": "MICHAEL",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD PSYCHIATRIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "LA11703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1133931",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Mamou, LA

Sources for this page

Verify at the official NPI Registry.