NPIMap

Organization Active NPI

Lafayette Surgical Hospital, LLC

Doing business as Lafayette Surgical Specialty Hospital

  • Specialist
  • Lafayette, LA
National Provider Identifier
1255736492
Registry record updated Feb 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
524 Issued in LA
Legal business name
LAFAYETTE SURGICAL HOSPITAL, LLC
Doing business as
Lafayette Surgical Specialty Hospital
Practice address
1025 Kaliste Saloom Rd
Lafayette, LA 70508-4963
Phone
(337) 237-3424
NPI assigned
Oct 30, 2014
Last updated
Feb 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2023

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

Authorized official

Name
Jennifer Boyd Baldock
Title
Officer and Authorized Official
Phone
(615) 234-5954

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 524 LA Primary

Addresses

Primary practice location

1025 Kaliste Saloom Rd
Lafayette, LA 70508-4963

Mailing address

1101 Kaliste Saloom Rd
Lafayette, LA 70508-5705
Phone (337) 769-4100

Other identifiers 2

IdentifierTypeStateIssuer
60695OtherLABLUE CROSS
1703036MedicaidLA

Other names 1

  • Lafayette Surgical Specialty Hospital Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040503001641 LA Part A Provider - Hospital 1951399583 1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lafayette, LA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1255736492. Details of each certification follow.

Hospital certification: CCN 190259

Legal name
LAFAYETTE SURGICAL HOSPITAL LLC
Doing business as
LAFAYETTE SURGICAL SPECIALTY HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Apr 17, 2004
Last certification
May 1, 2025
Beds
20
Ownership / control type
Physician ownership
Organization structure
LLCProprietary
Incorporated
Mar 8, 2002 in LA
Enrollment address
1101 Kaliste Saloom Rd
Lafayette, LA 70508-5705
Main/Primary Hospital Location
Hospital subgroups
Acute care, Short-term

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Lafayette Surgical Specialty HospitalCCN 190259 · All quality measures
Type
Acute Care Hospitals
Ownership
Physician
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

National Provider Directory

National Provider Directory

Locations

1103 Kaliste Saloom Rd
Ste 310
Lafayette, LA 70508
Phone (337) 261-5453

616 S Lewis St
Ste D
New Iberia, LA 70560
Phone (337) 769-4100

Ownership & related parties

All disclosed owners & managing parties 10

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
SP Holdco I Inc Organization, Brentwood, TN Corporation, Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2023 40.43%
National Surgical Hospitals, LLC Organization, Brentwood, TN LLC, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2023 40.43%
Jennifer B Baldock Individual Corporate OfficerOfficer & Authorized Official Sep 1, 2017
Jason Cormier Individual 5% Or Greater Direct Ownership InterestN/a Feb 1, 2022 6.02%
Surgery Partners Inc Organization, Brentwood, TN Corporation, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2023 40.43%
Buffy Domingue Individual Corporate OfficerHospital Ceo Feb 3, 2011
W-2 Managing EmployeeHospital Ceo Feb 3, 2011
NSH Louisiana LLC Organization, Brentwood, TN LLC, Owned by another organization or individual 5% Or Greater Direct Ownership Interest Feb 1, 2023 40.43%
Surgery Center Holdings Inc Organization, Brentwood, TN Corporation, Chain home office, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2023 40.43%
Bcpe Seminole Holdings II Intermediate LP Organization, Boston, MA Holding company, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Mar 31, 2023 9.38%
Surgery Center Holdings LLC Organization, Brentwood, TN LLC, For-profit, Owned by another organization or individual 5% Or Greater Indirect Ownership Interest Feb 1, 2023 40.43%

Owners & managing parties with NPI records 1

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 74

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 74

NPI Registry JSON

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

{
    "created_epoch": "1414627200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1675814400000",
    "number": "1255736492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 KALISTE SALOOM RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085705",
            "telephone_number": "337-769-4100"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 KALISTE SALOOM RD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705084963",
            "telephone_number": "337-237-3424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAFAYETTE SURGICAL HOSPITAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-30",
        "last_updated": "2023-02-08",
        "certification_date": "2023-02-08",
        "status": "A",
        "authorized_official_last_name": "BALDOCK",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "BOYD",
        "authorized_official_title_or_position": "OFFICER AND AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "615-234-5954"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "524",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "60695",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1703036",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lafayette Surgical Specialty Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lafayette Surgical Specialty Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.