Individual provider Active NPI

Nicholas Charles Patin, CRNA

  • Certified Registered Nurse Anesthetist
  • Lafayette, LA
National Provider Identifier
1639372105
Registry record updated Jul 22, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP05254 Issued in LA
Practice address
1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone
(337) 289-7991
NPI assigned
Jun 11, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X RN107416 LA
Certified Registered Nurse Anesthetist 367500000X AP05254 LA Primary

Addresses

Primary practice location

1214 Coolidge Blvd
Lafayette, LA 70503-2621

Mailing address

PO Box 1123
255 W Michigan Ave
Jackson, MI 49201-2218
Phone (800) 242-1131

Other practice location 1

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2574

Other identifiers 1

IdentifierTypeStateIssuer
1011312MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070813000787 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 3072604560 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lafayette Health Ventures IncGroup PAC ID 9335043074, 299 clinicians
Eunice Anesthesiology Group LLCGroup PAC ID 2365430758, 14 clinicians
Youngs Professional Services LLCGroup PAC ID 2163524992, 297 clinicians

Practice addresses (Care Compare)

1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone (337) 289-7991

3501 Hwy 190
Eunice, LA 70535-5129
Phone (337) 468-2767

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN107416LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Eunice Anesthesiology Group LLC CurrentSince Mar 26, 2025 Accepting new patients
Lafayette Health Ventures, Inc CurrentSince Apr 1, 2021 Accepting new patients
Lafayette Health Ventures Inc Current Accepting new patients
Los Anesthesia Services LLC CurrentSince Jan 18, 2026 Accepting new patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jan 1, 2026 Accepting new patients
Lafayette Health Ventures Inc CurrentSince Apr 1, 2021 Accepting new patients
DRS Burleigh, Dupleix and Rees Past Accepting new patients

Locations

210 Champagne Blvd
Breaux Bridge, LA 70517
Phone (337) 332-2178

1305 E Highway 90
Crowley, LA 70526
Phone (337) 783-3222

3501 Highway 190
Eunice, LA 70535
Phone (337) 580-7500

2810 Ambassador Caffery Pkwy
Lafayette, LA 70506
Phone (337) 593-5423

1211 Coolidge Blvd
Ste 302
Lafayette, LA 70503
Phone (337) 289-8245

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 371-3135

4212 W Congress St
Ste 3100
Lafayette, LA 70506
Phone (337) 703-3201

1000 W Pinhook Rd
Ste 305
Lafayette, LA 70503
Phone (337) 235-1600

1214 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

1000 W Pinhook Rd
Lafayette, LA 70503
Phone (337) 289-7311

2390 W Congress St
Lafayette, LA 70506
Phone (337) 261-6000

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

1211 Coolidge Blvd
#302
Lafayette, LA 70503
Phone (337) 289-8245

1100 Andre St
Ste 300
New Iberia, LA 70563
Phone (337) 364-9225

Organizations & group practices 8

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.

Hospital & facility affiliations 2

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

NPI Registry JSON

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

{
    "created_epoch": "1181520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784678400000",
    "number": "1639372105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1123",
            "address_2": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "800-242-1131",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1214 COOLIDGE BLVD",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705032621",
            "telephone_number": "337-289-7991"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4801 Ambassador Caffery Pkwy",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705086917",
            "country_code": "US",
            "telephone_number": "337-470-2574",
            "fax_number": "337-470-2605",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATIN",
        "first_name": "NICHOLAS",
        "middle_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-11",
        "last_updated": "2026-07-22",
        "certification_date": "2026-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "RN107416",
            "primary": false
        },
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP05254",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1011312",
            "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 Jul 22, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.