Freddie Joseph Fandal Jr., MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

024781 Issued in LA

Practice address

17695 Hwy 190
Port Barre, LA 70577

Phone

(337) 585-7898

Fax

(337) 585-7899

NPI assigned

Mar 21, 2006

Last updated

Dec 8, 2010By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

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

Specialty

Family PracticeAlso: Emergency Medicine

Education

Louisiana State University School of Medicine in Shreveport, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Opelousas General Health System Physician PracticesGroup PAC ID 9830340694, 62 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Opelousas General Health System Hospital, Opelousas, LA, CCN 190017
• Tri-Community Nursing Center Nursing home, Palmetto, LA, CCN 195552

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Acadian Hospitalist Group LLC

  • Internal Medicine Physician
  • Opelousas, LA
  • NPI 1487428082
  Medicare reassignment NPD Authorized official
• Opelousas General Health System Physician Practices

  • Family Medicine Physician
  • Opelousas, LA
  • NPI 1295098747
  Medicare reassignment Care Compare group NPD
• Opelousas General Health System

  dba Physician Practices

  • Surgery Physician
  • Opelousas, LA
  • NPI 1053317016
  NPD
• Opelousas General Health System

  dba Physician Practices

  • Surgery Physician
  • Opelousas, LA
  • NPI 1275794679
  NPD
• Opelousas General Hospital Authority

  • General Acute Care Hospital
  • Opelousas, LA
  • NPI 1447230388
  NPD (past)
• Peace Inc

  dba Tri Community Nursing Center

  • Skilled Nursing Facility
  • Palmetto, LA
  • NPI 1073556171
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Opelousas General Hospital Authority

  • General Acute Care Hospital
  • Opelousas, LA
  • NPI 1447230388
  Care Compare affiliation
• Peace Inc

  dba Tri Community Nursing Center

  • Skilled Nursing Facility
  • Palmetto, LA
  • NPI 1073556171

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1142899200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291766400000",
    "number": "1538128285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1338",
            "city": "PORT BARRE",
            "state": "LA",
            "postal_code": "70577",
            "telephone_number": "337-585-7898",
            "fax_number": "337-585-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17695 HWY 190",
            "city": "PORT BARRE",
            "state": "LA",
            "postal_code": "70577",
            "telephone_number": "337-585-7898",
            "fax_number": "337-585-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANDAL",
        "first_name": "FREDDIE",
        "middle_name": "JOSEPH",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-21",
        "last_updated": "2010-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "024781",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "080164292",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1430692",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Aigpharm LLC (Port Barre Drug Pharmacy)
• Aigpharm LLC (Port Barre Drug Pharmacy LTC)
• Dana Renee Armond, APRN-CNP
• Rhonda Gerace Bergeron, APRN, FNP
• Lauren Dauzat, FNP
• Eric Keith Fontenot, PT
• Emily Claire Henry, FNP
• Kens Thrifty Way Pharmacy and Home Medical Inc (Ken's Thrifty Way Pharmacy and Home Medical-Port Barre)
• Andrew Leblanc
• Jennifer Ewing Marchand, NP

• Family Medicine Physician in Port Barre, LA
• Providers in Port Barre, LA by specialty
• Family Medicine Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.