Individual provider Active NPI

Jeffrey Douglas Fontenot, MD

  • Internal Medicine Physician
  • Broussard, LA
National Provider Identifier
1346744570
Registry record updated Nov 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
328521 Issued in LA
Practice address
1122 South Bernard Rd
Suite B
Broussard, LA 70518
Phone
(337) 289-8933
NPI assigned
Mar 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 328521 LA Primary

Addresses

Primary practice location

1122 South Bernard Rd
Suite B
Broussard, LA 70518

Mailing address

PO Box 53092
Lafayette, LA 70505-3092
Phone (337) 289-8933

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
I20211105001523 LA Practitioner - Internal Medicine 8921351545 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lafayette Health Ventures IncGroup PAC ID 9335043074, 299 clinicians

Practice addresses (Care Compare)

1122 S Bernard Rd
Suite B
Broussard, LA 70518-7054
Phone (337) 703-6456

Hospital & facility affiliations

  • Lourdes Home Health Home health agency, Lafayette, LA, CCN 197057
  • Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Acadiana Imaging Services LLC CurrentSince Dec 6, 2021 Accepting new patients
Lafayette Health Ventures, Inc. CurrentSince Oct 11, 2021 Accepting new patients
Lafayette Health Ventures Inc CurrentSince Oct 11, 2021 Accepting new patients
Lafayette Health Ventures Inc Current Accepting new patients
Lafayette Health Ventures, Inc Internal Medicine Past Accepting new patients

Locations

1122 S Bernard Rd
Ste C
Broussard, LA 70518
Phone (337) 703-6476

1122 S Bernard Rd
Ste B
Broussard, LA 70518
Phone (337) 289-8933

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

4906 Ambassador Caffery Pkwy
Ste 1302
Lafayette, LA 70508
Phone (337) 235-7743

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

4212 W Congress St
Ste 3100
Lafayette, LA 70506
Phone (337) 703-3201

1216 Camellia Blvd
Lafayette, LA 70508
Phone (337) 769-0069

508 E Bridge St
Saint Martinville, LA 70582
Phone (337) 342-2706

2810 Bonin Rd
Youngsville, LA 70592
Phone (337) 857-5765

Interoperability endpoints

  • Direct secure messaging: jfontenot1420784@direct.ochsner.org

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 2

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": "1521590400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635897600000",
    "number": "1346744570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 53092",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705053092",
            "telephone_number": "337-289-8933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1122 SOUTH BERNARD RD",
            "address_2": "SUITE B",
            "city": "BROUSSARD",
            "state": "LA",
            "postal_code": "70518",
            "telephone_number": "337-289-8933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FONTENOT",
        "first_name": "JEFFREY",
        "middle_name": "DOUGLAS",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-03-21",
        "last_updated": "2021-11-03",
        "certification_date": "2021-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "328521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Broussard, LA

Sources for this page

Verify at the official NPI Registry.