Individual provider Active NPI

Tiffany Mary Dufrene, M.D.

  • Family Medicine Physician
  • Lake Charles, LA
National Provider Identifier
1225535818
Registry record updated Apr 27, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
325402 Issued in LA
Practice address
1525 Oak Park Blvd
Lake Charles, LA 70601-8849
Phone
(337) 494-6767
Fax
(337) 494-6750
NPI assigned
Apr 10, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 325402 LA Primary

Addresses

Primary practice location

1525 Oak Park Blvd
Lake Charles, LA 70601-8849

Mailing address

PO Box 123453 Dept 3453
Dallas, TX 75312-0001
Phone (337) 494-2772

Other identifiers 1

IdentifierTypeStateIssuer
325402OtherLASTATE LICENSE

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
I20220121001573 LA Practitioner - Family Practice 5991053043 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in Shreveport, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Thibodaux Regional Network Development CorporationGroup PAC ID 8224011754, 138 clinicians

Practice addresses (Care Compare)

602 N Acadia Rd
Contract Management Dept
Thibodaux, LA 70301-4823
Phone (985) 493-4907

Hospital & facility affiliations

  • Thibodaux Regional Medical Center Hospital, Thibodaux, LA, CCN 190004

Merit-based Incentive Payment System (MIPS)

Final score
82.55 of 100Reported as group
Quality
67.62
Promoting interoperability
100
Improvement activities
40
Cost
71.34

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lsuhsc Family Practice Center @ LCMH Family Medicine CurrentSince Dec 1, 2021 Accepting new patients
Thibodaux Regional Network Development Corporation CurrentSince Jan 9, 2023 Accepting new patients
Thibodaux Regional Network Development Corporation Current Accepting new patients
Thibodaux Regional Network Development Corporation CurrentSince Jan 9, 2023 Accepting new patients
Thibodaux Regional Health System Inc Past Accepting new patients

Locations

1525 Oak Park Blvd
Lake Charles, LA 70601
Phone (337) 494-2023

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

Organizations & group practices 5

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 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": "1523318400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651017600000",
    "number": "1225535818",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 123453 DEPT 3453",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "753120001",
            "telephone_number": "337-494-2772",
            "fax_number": "337-494-2928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1525 OAK PARK BLVD",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706018849",
            "telephone_number": "337-494-6767",
            "fax_number": "337-494-6750"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFRENE",
        "first_name": "TIFFANY",
        "middle_name": "MARY",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-04-10",
        "last_updated": "2022-04-27",
        "certification_date": "2022-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "325402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "325402",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.