Individual provider Active NPI

Bethany Ardoin Verret, PA-C

  • Physician Assistant
  • Lake Charles, LA
National Provider Identifier
1386163335
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
306455 Issued in LA
Practice address
1530 E McNeese St Ste 1
Lake Charles, LA 70607-4784
Phone
(337) 564-5322
NPI assigned
Sep 11, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA12054 TX
Physician Assistant 363A00000X 306455 LA Primary

Addresses

Primary practice location

1530 E McNeese St Ste 1
Lake Charles, LA 70607-4784

Mailing address

1917 Plantation Dr
Lake Charles, LA 70605-5265
Phone (337) 526-8547

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
I20220111002305 LA Practitioner - Physician Assistant 1254723877 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Louisiana State University School of Medicine in New Orleans, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Access Urgent Care IncGroup PAC ID 3678987435, 10 clinicians

Practice addresses (Care Compare)

1530 E McNeese St
Suite 1
Lake Charles, LA 70607-4784
Phone (337) 564-5322

2825 Country Club Rd
Suite a
Lake Charles, LA 70605-5915
Phone (337) 444-5867

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
90.84 of 100Reported as group
Quality
82.42
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
306455LAMDPhysician Assistant
PA12054TXMDPhysician Assistant

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": "1505088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1386163335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1917 PLANTATION DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706055265",
            "telephone_number": "337-526-8547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1530 E MCNEESE ST STE 1",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706074784",
            "telephone_number": "337-564-5322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERRET",
        "first_name": "BETHANY",
        "middle_name": "ARDOIN",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-11",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TX",
            "license": "PA12054",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "306455",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.