Individual provider Active NPI

Andrew Jude Leblanc, DNP(C), CRNA

  • Certified Registered Nurse Anesthetist
  • Mandeville, LA
National Provider Identifier
1225739477
Registry record updated Dec 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
231769 Issued in LA
Practice address
200 Greenleaves Blvd
Mandeville, LA 70448-7018
Phone
(855) 300-7525
NPI assigned
Mar 14, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 253383-30 WI
Registered Nurse 163W00000X RN147858 LA
Certified Registered Nurse Anesthetist 367500000X 231769 LA Primary

Addresses

Primary practice location

200 Greenleaves Blvd
Mandeville, LA 70448-7018

Mailing address

608 W Church St
Delcambre, LA 70528-3608

Other practice location 1

1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone (337) 289-7991

Other practice location 2

2810 Ambassador Caffery Pkwy
Lafayette, LA 70506-5906
Phone (337) 981-2949

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, AR, MN3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20230830004310 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810350386 Reassigns benefits to 2 organizations
I20241125003035 AR Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810350386 Reassigns benefits to 1 organization
I20250501001215 MN Practitioner - Certified Registered Nurse Anesthetist (Crna) 7810350386 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3110MNMDSports Vision Optometrist
RN147858LAMDRegistered Nurse
253383-30WIMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jul 31, 2023 Accepting new patients
Allina Health System Current Accepting new patients
Allina Health System CurrentSince Mar 1, 2025 Accepting new patients
Allina Health System Nurse Anesthetist, Certified Registered CurrentSince Mar 1, 2025 Accepting new patients
Galleria Anesthesia Associates, LLC CurrentSince Mar 1, 2025 Accepting new patients
Ans Services of Arkansas PA CurrentSince Nov 19, 2024 Accepting new patients

Locations

700 W Grove St
El Dorado, AR 71730
Phone (870) 863-2200

1001 Towson Ave
Fort Smith, AR 72901
Phone (479) 441-3980

67252 Industry Ln
Covington, LA 70433
Phone (985) 801-0259

555 Dr Michael Debakey Dr
Ste 102
Lake Charles, LA 70601
Phone (337) 439-6226

200 Greenleaves Blvd
Mandeville, LA 70448
Phone (855) 300-7525

1100 Andre St
Ste 300
New Iberia, LA 70563
Phone (337) 364-9225

701 Dellwood St S
Cambridge, MN 55008
Phone (763) 689-7700

2925 Chicago Ave
Minneapolis, MN 55407
Phone (612) 262-4813

265 Brookview Centre Way
Ste 203
Knoxville, TN 37919
Phone (865) 500-1254

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1678752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734825600000",
    "number": "1225739477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "608 W CHURCH ST",
            "city": "DELCAMBRE",
            "state": "LA",
            "postal_code": "705283608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 GREENLEAVES BLVD",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704487018",
            "telephone_number": "855-300-7525"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1214 Coolidge Blvd",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705032621",
            "country_code": "US",
            "telephone_number": "337-289-7991",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2810 Ambassador Caffery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705065906",
            "country_code": "US",
            "telephone_number": "337-981-2949",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEBLANC",
        "first_name": "ANDREW",
        "middle_name": "JUDE",
        "name_prefix": "Dr.",
        "credential": "DNP(C), CRNA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-14",
        "last_updated": "2024-12-22",
        "certification_date": "2024-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "253383-30",
            "primary": false
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "LA",
            "license": "RN147858",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "231769",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.