NPIMap

Individual provider Active NPI

Susila Shanmuganathan, M.D.

  • Family Medicine Physician
  • Lafayette, LA
National Provider Identifier
1447510300
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
207855 Issued in LA
Practice address
2390 W Congress St
Lafayette, LA 70506-4205
Phone
(337) 991-9276
NPI assigned
May 24, 2012
Last updated
Jul 21, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X NU
Family Medicine Physician 207Q00000X 207855 LA Primary

Addresses

Primary practice location

2390 W Congress St
Lafayette, LA 70506-4205

Mailing address

1509 Dulles Dr
Lafayette, LA 70506-3718
Phone (337) 991-9276

Other identifiers 1

IdentifierTypeStateIssuer
2300458MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160622000442 LA Practitioner - Family PracticePractitioner - Geriatric Medicine 1355589961 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family PracticeAlso: Geriatric Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
CH MSSP Services la LLCGroup PAC ID 6901206416, 44 clinicians
Lsuhn Billing LLCGroup PAC ID 0446337802, 203 clinicians
Curana Health of Louisiana LLCGroup PAC ID 4880731355, 140 clinicians

Practice addresses (Care Compare)

100 Kingston Rd
Sulphur, LA 70663-4016
Phone (337) 991-9276

2390 W Congress St
Lafayette, LA 70506-4205
Phone (337) 261-6000

2900 Westfork Dr
Suite 401
Baton Rouge, LA 70827-0004
Phone (877) 260-4747

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
207855LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lsuhn Billing LLC CurrentSince Apr 1, 2016 Accepting new patients
Curana Health of Louisiana LLC Family Medicine CurrentSince Apr 24, 2017 Accepting new patients
University Hospital & Clinics, Inc. CurrentSince May 16, 2016 Accepting new patients
University Hospital & Clinics Inc CurrentSince May 16, 2016 Accepting new patients
Hub City Physician Group, LLC CurrentSince Jul 9, 2016 Accepting new patients
Lsuhn Billing LLC Family Medicine CurrentSince Apr 1, 2016 Accepting new patients
Allaire Emergency Physicians LLC Past Accepting new patients
PMG Opco-Broussard LLC Past Accepting new patients
Hospice Care of Louisiana, LLC Family Medicine Past Accepting new patients

Locations

2900 Westfork Dr
Ste 401
Baton Rouge, LA 70827
Phone (225) 953-0895

1305 E Highway 90
Crowley, LA 70526
Phone (337) 783-3222

1509 Dulles Dr
Lafayette, LA 70506
Phone (337) 408-0803

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Camelot of BroussardBroussard, LA, CCN 195592 Skilled nursing facility Adp of the SNF Apr 17, 2025
Hospice Compassus- LafayetteLafayette, LA, CCN 191650 Hospice Contracted Managing Employee Aug 1, 2022

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 10

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.

Hospital & facility affiliations 5

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": "1337817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626825600000",
    "number": "1447510300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1509 DULLES DR",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705063718",
            "telephone_number": "337-991-9276",
            "fax_number": "337-943-0846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 W CONGRESS ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064205",
            "telephone_number": "337-991-9276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHANMUGANATHAN",
        "first_name": "SUSILA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-24",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "207855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2300458",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.