Budi N Sugeng, MD

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

MD200292 Issued in LA

Practice address

1305 N State St
Abbeville, LA 70510-2825

Phone

(337) 422-6240

Fax

(337) 422-6241

NPI assigned

Mar 13, 2007

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 3

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

Pediatric Medicine

Education

Icahn School of Medicine at Mount Sinai, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Southcare Medical LLCGroup PAC ID 4789808197, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: scm@scm.directmedgenehr.com

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Southcare Medical LLC

  • Rural Health Clinic/Center
  • Abbeville, LA
  • NPI 1215294830

  5% Or Greater Direct Ownership Interest, Corporate Director, Operational/Managerial Control, W-2 Managing Employee

  CMS ownership

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.

• Southcare Medical LLC

  • Rural Health Clinic/Center
  • Abbeville, LA
  • NPI 1215294830

  Pediatrics

  Medicare reassignment Care Compare group NPD
• Southcare Medical LLC

  • Primary Care Clinic/Center
  • Lafayette, LA
  • NPI 1093170433

  Pediatrics

  NPD Authorized official
• Our Lady of Lourdes Regional Medical Center, Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1598766495
  NPD (past)

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

{
    "created_epoch": "1173744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1649303330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1305 N STATE ST",
            "city": "ABBEVILLE",
            "state": "LA",
            "postal_code": "705102825",
            "telephone_number": "337-422-6240",
            "fax_number": "337-422-6241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N STATE ST",
            "city": "ABBEVILLE",
            "state": "LA",
            "postal_code": "705102825",
            "telephone_number": "337-422-6240",
            "fax_number": "337-422-6241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUGENG",
        "first_name": "BUDI",
        "middle_name": "N",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-13",
        "last_updated": "2023-03-07",
        "certification_date": "2022-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "MD200292",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1330531",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MD",
            "identifier": "200292",
            "state": "LA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA BOARD OF PHARMACY",
            "identifier": "33165",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Star Elite Enterprises LLC
• Sterling Emergency Medical Services, a Professional Corporation
• Mallory Elyse Leboeuf Stiles, PT,DPT
• Tammy Stutes
• Janet E Sudduth, CRNA
• Jacquelyn Suire, LPN
• Madilyn Suire, SLP
• Brian Sullivan, MD
• Torie Tauzin, FNP-C
• Nicole Theriot, RN

• Pediatrics Physician in Abbeville, LA
• Providers in Abbeville, LA by specialty
• Pediatrics Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.