Ty Anthony Gautreau, NP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

AP04859 Issued in LA

Practice address

12525 Perkins Rd
Baton Rouge, LA 70810-1907

Phone

(225) 819-8857

Fax

(225) 767-6822

NPI assigned

Feb 15, 2008

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lake Urgent Care Ascension LLCGroup PAC ID 0244479095, 22 clinicians

Convenient Care LLCGroup PAC ID 1153306816, 36 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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 and National Provider Directory roles.

• Convenient Care LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1164422630
  Medicare reassignment Care Compare group NPD
• Lake Urgent Care Ascension LLC

  • Urgent Care Clinic/Center
  • Prairieville, LA
  • NPI 1912243122
  Medicare reassignment Care Compare group NPD
• Convenient Care LLC

  • Urgent Care Clinic/Center
  • Hammond, LA
  • NPI 1225119225
  NPD
• Lake Urgent Care Ascension LLC

  • Urgent Care Clinic/Center
  • Saint Amant, LA
  • NPI 1487024618
  NPD
• Rao R. Narra M.D. & Associates Apmc

  • Specialist
  • Gonzales, LA
  • NPI 1972744407
  NPD (past)

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

{
    "created_epoch": "1203033600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1548438286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2762 CONTINENTAL DR",
            "address_2": "STE 201",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708083240",
            "telephone_number": "225-706-3033",
            "fax_number": "225-218-4888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12525 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101907",
            "telephone_number": "225-819-8857",
            "fax_number": "225-767-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAUTREAU",
        "first_name": "TY",
        "middle_name": "ANTHONY",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-15",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "AP04859",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1034789",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joshua Ryan Gautreau, LMT
• Lindsey Rose Gautreau
• Lisa Crawford Gautreau, MD
• Matthew J Gautreau, CRNA
• Patricia Ontko Gautreau, LOT
• Chad P Gautreaux, CRNA
• Emilee Anne Gautreaux, LCSW
• Grant Gerard Gautreaux, PHD
• Kourtney Angelle Gautreaux
• Shelly Marie Gautreaux, CRNA

• Family Nurse Practitioner in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Family Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2016; 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.