Nicole Gaudet Buuck
Individual provider Active NPI Physician Assistant · Gonzales, LA
NPI 1366745283 · NPPES record last updated Jul 31, 2013
Key facts
- NPI
- 1366745283
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- PA.200404 (LA)
- Practice address
- 1125 W Highway 30
Gonzales, LA 70737-5004 - Phone
- (225) 647-5098
- NPI assigned
- Dec 15, 2010
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 9
Hospital & facility affiliations 1
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- Other, 2010
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- WCS Professional Services of Louisiana LLC
Practice addresses (Care Compare)
3445 N Causeway Blvd
Suite 600
Metairie, LA 70002-3762
Phone (504) 609-3282
Hospital & facility affiliations
- Our Lady of the Lake Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130905000446 | LA | Practitioner - Physician Assistant | 0941443287 | Reassigns benefits to 6 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PA.200404 | LA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Convenient Care LLC | Current |
Accepting new patients | |
| Convenient Care LLC | Current |
Accepting new patients | |
| Restorixhealth at-Home, LLC | Current |
Accepting new patients | |
| WCS Professional Services of Louisiana, LLC | Current |
Accepting new patients | |
| Lake Urgent Care Ascension LLC | Current |
Accepting new patients |
Locations
12525 Perkins Rd
#B
Baton Rouge, LA 70810
Phone (225) 819-8857
10319 Jefferson Hwy
Baton Rouge, LA 70809
Phone (224) 214-9352
301 Memorial Dr
Donaldsonvlle, LA 70346
Phone (225) 473-7931
1125 W Highway 30
Gonzales, LA 70737
Phone (225) 621-2975
1776 N Airline Hwy
Ste A
Gonzales, LA 70737
Phone (225) 647-4988
8166 Main St
Houma, LA 70360
Phone (800) 456-9121
3445 N Causeway Blvd
Ste 600
Metairie, LA 70002
Phone (504) 835-4919
3017 N Causeway Blvd
Ste 203
Metairie, LA 70002
Phone (504) 833-9994
14350 Highway 73
Prairieville, LA 70769
Phone (225) 313-3930
40546 Highway 42
Prairieville, LA 70769
Phone (225) 744-4988
4608 Highway 1
Raceland, LA 70394
Phone (504) 537-6841
10714 Highway 431
Saint Amant, LA 70774
Phone (225) 644-0005
5266 Commerce St
St Francisvle, LA 70775
Phone (225) 635-3811
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | PA.200404 | LA | Yes |
Addresses
Primary practice location
1125 W Highway 30
Gonzales, LA 70737-5004
Mailing address
14332 Sommer LN
Gonzales, LA 70737-6670
Other providers in Gonzales, LA
- Tracy Mai Bui
- Lance Everett Bullock
- Quenterra Burd
- Lashawnda Burks
- La'Quesha J Butler
- Byron Robert Rome Apdc
- C&M Medical Services-St Elizabeth LLC
- Michael Caire
- Cajun Clinical Laboratory Services, LLC
- Elena M Campbell
All providers in Gonzales, LA · Physician Assistant in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 31, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.