Individual provider Active NPI

Maitram Nguyen

  • Physical Therapist
  • Zachary, LA
National Provider Identifier
1407640238
Registry record updated Apr 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
4845 Main St Ste C
Zachary, LA 70791-3943
Phone
(225) 286-0181
NPI assigned
Apr 7, 2025
Sex
Unspecified or another gender identity
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

4845 Main St Ste C
Zachary, LA 70791-3943

Mailing address

4324 S Sherwood Forest Blvd Ste B170
Baton Rouge, LA 70816-4481
Phone (225) 654-8208

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250722000653 LA Practitioner - Physical Therapist in Private Practice 0042726598 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Moreau Physical Therapy Inc.Group PAC ID 3173419298, 81 clinicians

Practice addresses (Care Compare)

4845 Main St
Suite C
Zachary, LA 70791-3943
Phone (225) 286-0181

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Alvin C Moreau Jr Licensed Physical Therapist DTD 01 15 82 Physical Therapist CurrentSince Apr 12, 2025 Accepting new patients
Moreau Physical Therapy Inc. Physical Therapist CurrentSince Apr 12, 2025 Accepting new patients
Alvin C Moreau Jr Licensed Physical Therapist DTD 01 15 82 Physical Therapist Past Accepting new patients

Locations

4971 Groom Rd
Baker, LA 70714
Phone (225) 775-3145

4314 S Sherwood Forest Blvd
Ste A150
Baton Rouge, LA 70816
Phone (225) 275-3177

18303 Perkins Rd E
Ste 407
Baton Rouge, LA 70810
Phone (225) 751-8512

9808 Bluebonnet Blvd
#201
Baton Rouge, LA 70810
Phone (225) 202-6124

4324 S Sherwood Frst
Ste B170
Baton Rouge, LA 70816

11424 Sullivan Rd
#A-C
Baton Rouge, LA 70818
Phone (225) 261-7021

4324 S Sherwood Forest Blvd
Ste 170
Baton Rouge, LA 70816

3129 Perkins Rd
Baton Rouge, LA 70808
Phone (225) 246-2076

3730 NE Evangeline Trwy
Ste D
Carencro, LA 70520
Phone (337) 469-3003

577 W Highway 30
Ste D
Gonzales, LA 70737
Phone (225) 462-2233

308 Dixie Plz
Natchitoches, LA 71457
Phone (318) 228-1034

9930 Lake Forest Blvd
Ste A
New Orleans, LA 70127
Phone (504) 245-2483

2633 Napoleon Ave
Ste 615
New Orleans, LA 70115
Phone (504) 895-0638

4027 I 49 S Service Rd
Opelousas, LA 70570
Phone (337) 948-4212

59295 River West Dr
Ste G
Plaquemine, LA 70764
Phone (225) 238-2955

16309 Highway 190
Port Barre, LA 70577
Phone (337) 585-3780

17534 Old Jefferson Hwy
Ste A1
Prairieville, LA 70769
Phone (225) 673-4370

4845 Main St
#C
Zachary, LA 70791
Phone (225) 286-0181

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.

NPI Registry JSON

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

{
    "created_epoch": "1743984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1407640238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4324 S SHERWOOD FOREST BLVD STE B170",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708164481",
            "telephone_number": "225-654-8208"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4845 MAIN ST STE C",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707913943",
            "telephone_number": "225-286-0181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "MAITRAM",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2025-04-07",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Zachary, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.