Individual provider Active NPI

Dwayne B Rabalais, PA

  • Physician Assistant
  • Baton Rouge, LA
National Provider Identifier
1609003706
Registry record updated Jun 16, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.200268 Issued in LA
Practice address
8080 Bluebonnet Blvd
Suite 1000
Baton Rouge, LA 70810-7827
Phone
(225) 924-2424
Fax
(225) 408-7899
NPI assigned
Jun 16, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.200268 LA Primary

Addresses

Primary practice location

8080 Bluebonnet Blvd
Suite 1000
Baton Rouge, LA 70810-7827

Mailing address

8080 Bluebonnet Blvd
Suite 1000
Baton Rouge, LA 70810-7827
Phone (225) 924-2424

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090925000009 LA Practitioner - Physician Assistant 2668528167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baton Rouge Orthopaedic Clinic LLCGroup PAC ID 3274446414, 142 clinicians

Practice addresses (Care Compare)

5000 Odonavan Blvd
Suite 514
Walker, LA 70785-6353
Phone (225) 380-1312

8080 Bluebonnet Blvd
Baton Rouge, LA 70810-7827

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.200268LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Orthopaedic Clinic CurrentSince Aug 14, 2009 Accepting new patients
Baton Rouge Orthopaedic Clinic, LLC CurrentSince Aug 14, 2009 Accepting new patients

Locations

8080 Bluebonnet Blvd
Ste 1000
Baton Rouge, LA 70810
Phone (225) 408-6633

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1245110400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245110400000",
    "number": "1609003706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8080 BLUEBONNET BLVD",
            "address_2": "SUITE 1000",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107827",
            "telephone_number": "225-924-2424",
            "fax_number": "225-408-7899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8080 BLUEBONNET BLVD",
            "address_2": "SUITE 1000",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708107827",
            "telephone_number": "225-924-2424",
            "fax_number": "225-408-7899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABALAIS",
        "first_name": "DWAYNE",
        "middle_name": "B",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-06-16",
        "last_updated": "2009-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200268",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.