NPIMap

Individual provider Active NPI

Jessica R. Peluso, PA-C

  • Medical Physician Assistant
  • Natchitoches, LA
National Provider Identifier
1548215403
Registry record updated Jan 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
A10533 Issued in LA
Practice address
601 Keyser Ave
Natchitoches, LA 71457-6020
Phone
(318) 214-5770
NPI assigned
May 22, 2006
Last updated
Jan 12, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2004012769 MO
Medical Physician Assistant 363AM0700X A10533 LA Primary

Addresses

Primary practice location

601 Keyser Ave
Natchitoches, LA 71457-6020

Mailing address

PO Box 2475
Natchitoches, LA 71457-2475
Phone (318) 663-6131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090820000147 LA Practitioner - Physician Assistant 1658317706 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
NRMC Physician Ipa IncGroup PAC ID 9234400300, 30 clinicians

Practice addresses (Care Compare)

501 Keyser Ave
Natchitoches, LA 71457-6018
Phone 31821457701144

601 Keyser Ave
Natchitoches, LA 71457-6020
Phone 31821457704833

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2004012769MOMDPhysician Assistant
A10533LAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
NRMC Physician Ipa Inc CurrentSince Feb 12, 2020 Accepting new patients
Rapides Healthcare System LLC CurrentSince May 12, 2014 Accepting new patients
Calcasieu Urgent Care, LLC CurrentSince Jul 7, 2018 Accepting new patients
Rapides Healthcare System, LLC CurrentSince May 12, 2014 Accepting new patients
Calcasieu Urgent Care LLC CurrentSince Jul 7, 2018 Accepting new patients
DM Properties of Lafayette, LLC CurrentSince Dec 19, 2013 Accepting new patients
Nes Louisiana Inc CurrentSince Oct 12, 2016 Accepting new patients
DM Properties of Lafayette, LLC CurrentSince Dec 19, 2013 Accepting new patients
Rapides Regional Physician Group Specialty Care, LLC PastSince Oct 12, 2019 Accepting new patients
Cenla Family Medical Center, LLC Past Accepting new patients
NRMC Physician Ipa Inc Past Accepting new patients

Locations

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

3601 Jackson Street Ext
Alexandria, LA 71303
Phone (318) 787-6877

2640 Country Club Rd
Ste 400
Lake Charles, LA 70605
Phone (337) 426-0919

501 Keyser Ave
Natchitoches, LA 71457
Phone (318) 214-4200

601 Keyser Ave
Natchitoches, LA 71457
Phone (318) 214-4200

Organizations & group practices 12

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 24

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

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610409600000",
    "number": "1548215403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2475",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714572475",
            "telephone_number": "318-663-6131"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 KEYSER AVE",
            "city": "NATCHITOCHES",
            "state": "LA",
            "postal_code": "714576020",
            "telephone_number": "318-214-5770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELUSO",
        "first_name": "JESSICA",
        "middle_name": "R.",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2021-01-12",
        "certification_date": "2021-01-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "MO",
            "license": "2004012769",
            "primary": false
        },
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "A10533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Natchitoches, LA

Sources for this page

Verify at the official NPI Registry.