Individual provider Active NPI

Thomas Perkins, M.D.

  • Family Medicine Physician
  • Prairieville, LA
National Provider Identifier
1508859042
Registry record updated Jun 10, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
021555 Issued in LA
Practice address
17609 Old Jefferson Hwy Ste D
Prairieville, LA 70769-3980
Phone
(225) 765-5500
Fax
(225) 677-9695
NPI assigned
Aug 30, 2005
Last updated
Jun 10, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 021555 LA Primary

Addresses

Primary practice location

17609 Old Jefferson Hwy Ste D
Prairieville, LA 70769-3980

Mailing address

17609 Old Jefferson Hwy Ste D
Prairieville, LA 70769-3980
Phone (225) 765-5500

Other identifiers 1

IdentifierTypeStateIssuer
1950424MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address tperkins3469@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
I20050210000684 LA Practitioner - General Practice 0345292074 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
General Practice
Education
Louisiana State University School of Medicine in Shreveport, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

17609 Old Jefferson Hwy
Suite D
Prairieville, LA 70769-3980
Phone (225) 647-8511

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021555LAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC Family Medicine CurrentSince Mar 1, 2019 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince Mar 1, 2019 Accepting new patients
Lake Urgent Care Ascension LLC CurrentSince Jul 13, 2013 Accepting new patients
Lake Urgent Care Ascension LLC CurrentSince Jul 13, 2013 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients
Ascension Surgical Associates, LLC Past Accepting new patients
Radiology Associates LLC Past Accepting new patients
Olol-Ascension Family Medicine Past Accepting new patients

Locations

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

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

1702 N Burnside Ave
#B
Gonzales, LA 70737
Phone (225) 647-8319

2647 S Saint Elizabeth Blvd
Ste 100
Gonzales, LA 70737
Phone (225) 743-2707

2647 S Saint Elizabeth Blvd
Ste 125
Gonzales, LA 70737
Phone (225) 647-9675

14350 Highway 73
Prairieville, LA 70769
Phone (225) 313-3930

17609 Old Jefferson Hwy
Prairieville, LA 70769
Phone (225) 677-7060

17609 Old Jefferson Hwy
Ste D
Prairieville, LA 70769
Phone (225) 677-9595

Organizations & group practices 8

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 3

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": "1125360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1508859042",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17609 OLD JEFFERSON HWY STE D",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693980",
            "telephone_number": "225-765-5500",
            "fax_number": "225-677-9695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17609 OLD JEFFERSON HWY STE D",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693980",
            "telephone_number": "225-765-5500",
            "fax_number": "225-677-9695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "THOMAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-30",
        "last_updated": "2021-06-10",
        "certification_date": "2021-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "021555",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1950424",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tperkins3469@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "tperkins3469@direct.casso.us.com",
            "address_1": "17609 Old Jefferson Hwy Ste D",
            "city": "Prairieville",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707693980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "17609 Old Jefferson Hwy Ste D",
            "city": "Prairieville",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707693980",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Prairieville, LA

Sources for this page

Verify at the official NPI Registry.