Individual provider Active NPI

Jade Nicole Gautreau, P.A.

  • Physician Assistant
  • Baton Rouge, LA
National Provider Identifier
1467802603
Registry record updated Jun 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
302301 Issued in LA
Practice address
8080 Bluebonnet Blvd
Suite 1000
Baton Rouge, LA 70810-7827
Phone
(225) 924-2424
Fax
(225) 408-7984
NPI assigned
Jun 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 302301 LA Primary

Addresses

Primary practice location

8080 Bluebonnet Blvd
Suite 1000
Baton Rouge, LA 70810-7827

Mailing address

8080 Bluebonnet Blvd
Suite 1000
Baton Rouge, LA 70810-7827
Phone (225) 924-2424

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
I20160712000248 LA Practitioner - Physician Assistant 9537451562 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

8080 Bluebonnet Blvd
Baton Rouge, LA 70810-7827

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Orthopaedic Clinic CurrentSince Jul 1, 2016 Accepting new patients
Baton Rouge Orthopaedic Clinic, LLC CurrentSince Jul 1, 2016 Accepting new patients

Locations

8080 Bluebonnet Blvd
Ste 1000
Baton Rouge, LA 70810
Phone (225) 408-6633

Organizations & group practices 2

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": "1466294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466294400000",
    "number": "1467802603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 BLUEBONNET BLVD",
            "address_2": "SUITE 1000",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107827",
            "telephone_number": "225-924-2424",
            "fax_number": "225-408-7984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 BLUEBONNET BLVD",
            "address_2": "SUITE 1000",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107827",
            "telephone_number": "225-924-2424",
            "fax_number": "225-408-7984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTREAU",
        "first_name": "JADE",
        "middle_name": "NICOLE",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-19",
        "last_updated": "2016-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "302301",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.