Individual provider Active NPI

Luiz C Dearaujo, M.D.

  • Neurological Surgery Physician
  • Lafayette, LA
National Provider Identifier
1528014586
Registry record updated Jun 5, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Neurological Surgery PhysicianTaxonomy code 207T00000X
License
06212R Issued in LA
Practice address
116 Hospital Dr
Suite a
Lafayette, LA 70503-2819
Phone
(337) 269-6004
Fax
(337) 261-9003
NPI assigned
May 25, 2006
Last updated
Jun 5, 2014By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 5, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Neurological Surgery Physician 207T00000X 06212R LA Primary

Addresses

Primary practice location

116 Hospital Dr
Suite a
Lafayette, LA 70503-2819

Mailing address

116 Hospital Dr
Suite a
Lafayette, LA 70503-2819
Phone (337) 269-6004

Other identifiers 1

IdentifierTypeStateIssuer
1335517MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
06212RLAMDNeurological Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Stephen Goldware, M.D. a Professional Medical Corporation Neurological Surgery Past Accepting new patients
Kothapalli & Kothapalli LTD, Apmc Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1148515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401926400000",
    "number": "1528014586",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 HOSPITAL DR",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032819",
            "telephone_number": "337-269-6004",
            "fax_number": "337-261-9003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "116 HOSPITAL DR",
            "address_2": "SUITE A",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032819",
            "telephone_number": "337-269-6004",
            "fax_number": "337-261-9003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARAUJO",
        "first_name": "LUIZ",
        "middle_name": "C",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-25",
        "last_updated": "2014-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207T00000X",
            "taxonomy_group": "",
            "desc": "Neurological Surgery",
            "state": "LA",
            "license": "06212R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1335517",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.