Individual provider Active NPI

Benjamin Blair Gautreaux, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Hammond, LA
National Provider Identifier
1477841674
Registry record updated Dec 10, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP06520 Issued in LA
Practice address
15790 Paul Vega MD Dr
Anesthesia Department
Hammond, LA 70403-1434
Phone
(985) 230-1682
Fax
(985) 230-1617
NPI assigned
Jul 21, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP06520 LA Primary

Addresses

Primary practice location

15790 Paul Vega MD Dr
Anesthesia Department
Hammond, LA 70403-1434

Mailing address

PO Box 2668
Hammond, LA 70404-2668
Phone (985) 230-2198

Other identifiers 2

IdentifierTypeStateIssuer
2157809MedicaidLA
AP06520OtherLACRNA LICENSE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230324000777 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 0547431975 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Zephyr Anesthesia LLCGroup PAC ID 1658559125, 161 clinicians

Practice addresses (Care Compare)

1125 W Hwy 30
Gonzales, LA 70737-5004
Phone (225) 765-6565

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
AP06520LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 3, 2023 Accepting new patients
Northlake Endoscopy, LLC Current Accepting new patients
Gastroenterology Anesthesia LLC CurrentSince Feb 10, 2023 Accepting new patients
Zephyr Anesthesia, LLC Nurse Anesthetist, Certified Registered CurrentSince May 1, 2025 Accepting new patients
North Oaks Medical Center, LLC Past Accepting new patients
North Oaks Medical Center, LLC Past Accepting new patients

Locations

7015 Highway 190 East Service Rd
Ste 103
Covington, LA 70433
Phone (985) 273-3915

1125 W Highway 30
Gonzales, LA 70737
Phone (225) 621-2975

16061 Doctors Blvd
Ste A
Hammond, LA 70403
Phone (985) 345-6090

694 Belle Terre Blvd
La Place, LA 70068
Phone (985) 359-6694

1100 Andre St
Ste 300
New Iberia, LA 70563
Phone (337) 364-9225

2309 E Main St
Ste 300
New Iberia, LA 70560
Phone (337) 560-1801

2701 Napoleon Ave
New Orleans, LA 70115
Phone (504) 267-2805

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.

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": "1311206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1386633600000",
    "number": "1477841674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2668",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704042668",
            "telephone_number": "985-230-2198",
            "fax_number": "985-230-2159"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15790 PAUL VEGA MD DR",
            "address_2": "ANESTHESIA DEPARTMENT",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031434",
            "telephone_number": "985-230-1682",
            "fax_number": "985-230-1617"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTREAUX",
        "first_name": "BENJAMIN",
        "middle_name": "BLAIR",
        "name_prefix": "Mr.",
        "credential": "C.R.N.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-21",
        "last_updated": "2013-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP06520",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2157809",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CRNA LICENSE",
            "identifier": "AP06520",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2013; 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.