Individual provider Active NPI

Luke Gerald Guillot, M.D.

  • Emergency Medicine Physician
  • Deland, FL
National Provider Identifier
1649561671
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
323523 Issued in LA
Practice address
701 Plymouth Ave
Deland, FL 32120-9430
Phone
(386) 943-4522
NPI assigned
Apr 25, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X ME119472 FL
Emergency Medicine Physician 207P00000X 323523 LA Primary

Addresses

Primary practice location

701 Plymouth Ave
Deland, FL 32120-9430

Mailing address

PO Box 9430
Daytona Beach, FL 32120-9430
Phone (386) 274-7800

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200710000870 LA Practitioner - Emergency Medicine 8224253877 Reassigns benefits to 7 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Professional Emergency Physician Associates, LLCGroup PAC ID 1759317092, 78 clinicians

Practice addresses (Care Compare)

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 765-8826

Hospital & facility affiliations

  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
ME119472FLMDEmergency Medicine Physician
323523LAMDEmergency Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Coolidge Emergency Group LLC Emergency Medicine CurrentSince Sep 5, 2020 Accepting new patients
East Baton Rouge Emergency Physicians Group, LLC Emergency Medicine CurrentSince Jun 30, 2020 Accepting new patients
Ambassador Emergency Group LLC Emergency Medicine CurrentSince Sep 5, 2020 Accepting new patients
St Tammany Emergency Physicians Group LLC Emergency Medicine CurrentSince Jun 30, 2020 Accepting new patients
Professional Emergency Physician Associates, LLC Emergency Medicine CurrentSince Jun 30, 2020 Accepting new patients
Ascension Emergency Physicians LLC Emergency Medicine CurrentSince Mar 15, 2024 Accepting new patients
Thibodaux Emergency Physicians Group LLC Emergency Medicine CurrentSince Jun 30, 2020 Accepting new patients

Locations

Dept AT952639
Atlanta, GA 31192

5439 Airline Hwy
Baton Rouge, LA 70805
Phone (225) 358-2280

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

5000 Hennessy Blvd
Ste B
Baton Rouge, LA 70808

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

1125 W Highway 30
Gonzales, LA 70737
Phone (225) 621-2975

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

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

2929 Highway 190
Mandeville, LA 70471
Phone (985) 773-1550

602 N Acadia Rd
Thibodaux, LA 70301
Phone (985) 493-4544

5000 Odonavan Blvd
Walker, LA 70785
Phone (225) 214-4200

6300 Main St
Zachary, LA 70791
Phone (225) 570-2618

Organizations & group practices 7

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 1

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": "1303689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1649561671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9430",
            "city": "DAYTONA BEACH",
            "state": "FL",
            "postal_code": "321209430",
            "telephone_number": "386-274-7800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 PLYMOUTH AVE",
            "city": "DELAND",
            "state": "FL",
            "postal_code": "321209430",
            "telephone_number": "386-943-4522"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GUILLOT",
        "first_name": "LUKE",
        "middle_name": "GERALD",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-25",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME119472",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "323523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Deland, FL

Sources for this page

Verify at the official NPI Registry.