Individual provider Active NPI

Kaley Marie Duplantis

  • Physician Assistant
  • Thibodaux, LA
National Provider Identifier
1356995096
Registry record updated Mar 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA320125 Issued in LA
Practice address
305 E 1St St
Thibodaux, LA 70301
Phone
(985) 228-6028
NPI assigned
Jul 31, 2019
Last updated
Mar 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 6, 2024

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 PA320125 LA Primary

Addresses

Primary practice location

305 E 1St St
Thibodaux, LA 70301

Mailing address

305 E 1St St
Thibodaux, LA 70301-3341
Phone (985) 859-7134

Other practice location 1

602 N Acadia Rd
Thibodaux, LA 70301-4823
Phone (985) 447-5500

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
I20190916000866 LA Practitioner - Physician Assistant 0446589501 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bayoumd Urgent Healthcare LLCGroup PAC ID 6507217452, 9 clinicians

Practice addresses (Care Compare)

305 E 1St St
Thibodaux, LA 70301-3341
Phone (985) 228-6028

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA320125LAMDPhysician 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1564531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709683200000",
    "number": "1356995096",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 E 1ST ST",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703013341",
            "telephone_number": "985-859-7134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 E 1ST ST",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "70301",
            "telephone_number": "985-228-6028"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "602 N Acadia Rd",
            "address_purpose": "LOCATION",
            "city": "Thibodaux",
            "state": "LA",
            "postal_code": "703014823",
            "country_code": "US",
            "telephone_number": "985-447-5500",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DUPLANTIS",
        "first_name": "KALEY",
        "middle_name": "MARIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-31",
        "last_updated": "2024-03-06",
        "certification_date": "2024-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA320125",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

Verify at the official NPI Registry.