Individual provider Active NPI

Brian W. Binck, MD

  • Pediatric Critical Care Medicine Physician
  • Baton Rouge, LA
National Provider Identifier
1386735645
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Critical Care Medicine PhysicianTaxonomy code 2080P0203X
License
C10007706 Issued in DE
Practice address
8200 Constantin Blvd Ste 200
Baton Rouge, LA 70809-3481
Phone
(225) 709-8633
Fax
(225) 767-6721
NPI assigned
Sep 28, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Critical Care Medicine Physician 2080P0203X MD.203225 LA
Pediatric Emergency Medicine (Pediatrics) Physician 2080P0204X 203225 LA
Pediatric Critical Care Medicine Physician 2080P0203X C10007706 DE Primary

Addresses

Primary practice location

8200 Constantin Blvd Ste 200
Baton Rouge, LA 70809-3481

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (337) 470-2605

Other practice location 1

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508-6902
Phone (337) 470-2605

Other practice location 2

8300 Constantin Blvd
Baton Rouge, LA 70809-3489
Phone (225) 374-1468

Other identifiers 5

IdentifierTypeStateIssuer
4084594MedicaidMD
91013900MedicaidFL
101461810MedicaidPA
0074420MedicaidNJ
MD.203225OtherLASTATE LICENSE

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bbinck15037@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

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
I20110106000615 LA Practitioner - Pediatric MedicinePractitioner - Critical Care (Intensivists) 3476548405 Reassigns benefits to 3 organizations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
C10007706DEMDPediatric Critical Care Medicine Physician
MD.203225LAMDPediatric Critical Care Medicine Physician
203225LAMDPediatric Emergency Medicine (Pediatrics) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes Physician Group LLC CurrentSince Jul 1, 2024 Accepting new patients
Our Lady of the Lake Physician Group, LLC CurrentSince Jun 3, 2022 Accepting new patients
Pediatric Intensivists of la, LLC CurrentSince Nov 23, 2010 Accepting new patients
Our Lady of the Lake Hospital Inc. Past Accepting new patients
Our Lady of the Lake Physician Group LLC PastSince Nov 14, 2012 Accepting new patients

Locations

7777 Hennessy Blvd
Ste 103
Baton Rouge, LA 70808
Phone (225) 215-2255

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

8300 Constantin Blvd
Baton Rouge, LA 70809
Phone (225) 374-1410

8200 Constantin Blvd
Ste 200
Baton Rouge, LA 70809
Phone (225) 709-8633

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 371-3135

Interoperability endpoints

  • FHIR API: https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/R4/

Organizations & group practices 6

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": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1739750400000",
    "number": "1386735645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "337-470-2605",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8200 CONSTANTIN BLVD STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093481",
            "telephone_number": "225-709-8633",
            "fax_number": "225-767-6721"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4600 Ambassador Caffery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705086902",
            "country_code": "US",
            "telephone_number": "337-470-2605",
            "fax_number": "337-470-4595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8300 Constantin Blvd",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708093489",
            "country_code": "US",
            "telephone_number": "225-374-1468",
            "fax_number": "225-374-1626",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BINCK",
        "first_name": "BRIAN",
        "middle_name": "W.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "LA",
            "license": "MD.203225",
            "primary": false
        },
        {
            "code": "2080P0204X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Emergency Medicine",
            "state": "LA",
            "license": "203225",
            "primary": false
        },
        {
            "code": "2080P0203X",
            "taxonomy_group": "",
            "desc": "Pediatrics, Pediatric Critical Care Medicine",
            "state": "DE",
            "license": "C10007706",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4084594",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "91013900",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "101461810",
            "state": "PA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0074420",
            "state": "NJ"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "MD.203225",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bbinck15037@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bbinck15037@direct.casso.us.com",
            "address_1": "7777 Hennessy Blvd Suite 103",
            "address_2": "Pediatric Intensivists of LA",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70808",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR APO",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "7777 Hennessy Blvd Suite 103",
            "address_2": "Pediatric Intensivists of LA",
            "city": "Baton Rouge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.