Individual provider Active NPI

Robert P Guilbault III, MD

  • Family Medicine Physician
  • Mandeville, LA
National Provider Identifier
1275581092
Registry record updated Mar 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.12621R Issued in LA
Practice address
521 Asbury Drive
Mandeville, LA 70471
Phone
(985) 630-9618
Fax
(985) 231-7010
NPI assigned
May 4, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2018

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 MD.12621R LA Primary

Addresses

Primary practice location

521 Asbury Drive
Mandeville, LA 70471

Mailing address

521 Asbury Drive
Mandeville, LA 70471
Phone (985) 630-9618

Other identifiers 1

IdentifierTypeStateIssuer
1541907MedicaidLA

Other names 1

  • Dr. Paul Guilbault Other name

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
I20070124000712 LA Practitioner - Family Practice 6608877279 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

521 Asbury Dr
Mandeville, LA 70471-3132
Phone (985) 630-9618

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Paul Guilbault MD, Family Medicine, LLC CurrentSince Mar 1, 2017 Accepting new patients
Mandeville Private Physician Group Family Medicine Past Accepting new patients

Locations

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

521 Asbury Dr
Mandeville, LA 70471
Phone (985) 630-9618

450 N Causeway Blvd
Ste E
Mandeville, LA 70448
Phone (985) 317-8001

Organizations & group practices 2

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 13

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521590400000",
    "number": "1275581092",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "521 ASBURY DRIVE",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "70471",
            "telephone_number": "985-630-9618",
            "fax_number": "985-231-7010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "521 ASBURY DRIVE",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "70471",
            "telephone_number": "985-630-9618",
            "fax_number": "985-231-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILBAULT",
        "first_name": "ROBERT",
        "middle_name": "P",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-04",
        "last_updated": "2018-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.12621R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1541907",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PAUL",
            "last_name": "GUILBAULT",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mandeville, LA

Sources for this page

Verify at the official NPI Registry.