Individual provider Active NPI

Michael Clemmons, MD

  • Emergency Medicine Physician
  • Lafayette, LA
National Provider Identifier
1295224723
Registry record updated Jul 4, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
330577 Issued in LA
Practice address
1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone
(337) 609-1159
Fax
(337) 371-4684
NPI assigned
May 10, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 4, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME149135 FL
Emergency Medicine Physician 207P00000X 330577 LA Primary

Addresses

Primary practice location

1214 Coolidge Blvd
Lafayette, LA 70503-2621

Mailing address

1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone (337) 609-1159

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
I20220705002332 LA Practitioner - Emergency Medicine 0648671479 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coolidge Emergency Group LLCGroup PAC ID 4880846427, 25 clinicians

Practice addresses (Care Compare)

1214 Coolidge Blvd
Lafayette, LA 70503-2696
Phone (337) 289-7991

Hospital & facility affiliations

  • Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002

Merit-based Incentive Payment System (MIPS)

Final score
96.73 of 100Reported as group
Quality
84.95
Improvement activities
40
Cost
85.77

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
330577LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Crowley Emergency Group LLC Emergency Medicine CurrentSince Jun 8, 2022 Accepting new patients
Ambassador Emergency Group LLC Emergency Medicine CurrentSince Jul 18, 2022 Accepting new patients
Coolidge Emergency Group LLC Emergency Medicine CurrentSince May 23, 2022 Accepting new patients

Locations

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

2810 Ambassador Caffery Pkwy
Lafayette, LA 70506
Phone (337) 593-5423

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

Interoperability endpoints

  • Direct secure messaging: mclemmons397248@direct.ochsner.org

Organizations & group practices 3

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": "1525910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656892800000",
    "number": "1295224723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1214 COOLIDGE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032621",
            "telephone_number": "337-609-1159",
            "fax_number": "337-371-4684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 COOLIDGE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032621",
            "telephone_number": "337-609-1159",
            "fax_number": "337-371-4684"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMMONS",
        "first_name": "MICHAEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-10",
        "last_updated": "2022-07-04",
        "certification_date": "2022-07-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME149135",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "330577",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.