Individual provider Active NPI

David Michael Grace, M.D.

  • Internal Medicine Physician
  • Lafayette, LA
National Provider Identifier
1225030588
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
200024 Issued in LA
Practice address
110 Queen of Peace Dr
Lafayette, LA 70508-5383
Phone
(337) 354-1185
NPI assigned
Jun 1, 2005
Last updated
Jun 11, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 200024 LA Primary

Addresses

Primary practice location

110 Queen of Peace Dr
Lafayette, LA 70508-5383

Mailing address

200 Corporate Blvd
Ste 201
Lafayette, LA 70508-3870
Phone (337) 354-1185

Other identifiers 1

IdentifierTypeStateIssuer
1575461MedicaidLA

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
I20050602001094 LA Practitioner - Internal MedicinePractitioner - Emergency Medicine 5597708339 Reassigns benefits to 5 organizations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ambassador Physician Services LLC CurrentSince Aug 25, 2006 Accepting new patients
Main Street Physician Services LLC CurrentSince Aug 1, 2015 Accepting new patients
Opelousas Physician Services LLC CurrentSince Jul 1, 2013 Accepting new patients
St Martin Physician Services LLC CurrentSince Apr 1, 2013 Accepting new patients
Hub City Physician Group, LLC CurrentSince Sep 7, 2019 Accepting new patients
Sunnyside Emergency Group a Professional LLC PastSince Jun 1, 2014 Accepting new patients
Yakima Emergency Group a Professional Limited Liability Com PastSince Feb 19, 2014 Accepting new patients
Olney Emergency Group, a Professional LLC PastSince Mar 1, 2019 Accepting new patients
Spokane Emergency Group, a Professional LLC PastSince Jan 25, 2016 Accepting new patients
Milroy Emergency Group a Professional LLC PastSince Mar 1, 2019 Accepting new patients
Spokane Physician Services, a Professional LLC PastSince Feb 1, 2016 Accepting new patients

Locations

210 Champagne Blvd
Breaux Bridge, LA 70517
Phone (337) 332-2178

1305 E Highway 90
Crowley, LA 70526
Phone (337) 783-3222

200 Corporate Blvd
Lafayette, LA 70508

200 Corporate Blvd
Ste 201
Lafayette, LA 70508

310 Youngsville Hwy
Lafayette, LA 70508
Phone (337) 837-5250

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 371-3135

2315 E Main St
New Iberia, LA 70560
Phone (337) 364-0441

2315 E Main St
Fl 3
New Iberia, LA 70560
Phone (337) 369-1100

600 N Lewis St
New Iberia, LA 70563
Phone (337) 365-7311

539 E Prudhomme St
Opelousas, LA 70570
Phone (337) 943-7128

Interoperability endpoints

  • Direct secure messaging: dgrace1443576@direct.ochsner.org

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1117584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1225030588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 CORPORATE BLVD",
            "address_2": "STE 201",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705083870",
            "telephone_number": "337-354-1185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 QUEEN OF PEACE DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085383",
            "telephone_number": "337-354-1185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRACE",
        "first_name": "DAVID",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-01",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "200024",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1575461",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.