Individual provider Active NPI

Lindsay A Dufresne, PA-C

  • Physician Assistant
  • Thibodaux, LA
National Provider Identifier
1346855715
Registry record updated Sep 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
324325 Issued in LA
Practice address
602 N Acadia Rd
Thibodaux, LA 70301-4823
Phone
(985) 447-5500
NPI assigned
Sep 12, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 324325 LA Primary

Addresses

Primary practice location

602 N Acadia Rd
Thibodaux, LA 70301-4823

Mailing address

PO Box 1162
Gramercy, LA 70052-1162
Phone (225) 772-7893

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201014003510 LA Practitioner - Physician Assistant 9931529849 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Lafayette Chiropractic Institute, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Matherne Dermatology LLCGroup PAC ID 6103189311, 2 clinicians

Practice addresses (Care Compare)

101 Picciola Pkwy
Cut Off, LA 70345-3572
Phone (985) 446-5888

1731 Lutcher Ave
Lutcher, LA 70071-5151
Phone (985) 446-5888

416 Hwy 308
Thibodaux, LA 70301-5752
Phone (985) 446-5888

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
324325LAMDPhysician Assistant

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.

NPI Registry JSON

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

{
    "created_epoch": "1599868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599868800000",
    "number": "1346855715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1162",
            "city": "GRAMERCY",
            "state": "LA",
            "postal_code": "700521162",
            "telephone_number": "225-772-7893"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 N ACADIA RD",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703014823",
            "telephone_number": "985-447-5500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUFRESNE",
        "first_name": "LINDSAY",
        "middle_name": "A",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-09-12",
        "last_updated": "2020-09-12",
        "certification_date": "2020-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "324325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.