Individual provider Active NPI

Victor Wayne Fuselier, PA

  • Surgical Physician Assistant
  • Baton Rouge, LA
National Provider Identifier
1659356301
Registry record updated Apr 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
A10230 Issued in LA
Practice address
5231 Brittany Dr
Baton Rouge, LA 70808-9143
Phone
(225) 769-0933
Fax
(225) 769-5008
NPI assigned
Dec 14, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X A10230 LA Primary

Addresses

Primary practice location

5231 Brittany Dr
Baton Rouge, LA 70808-9143

Mailing address

5231 Brittany Dr
Baton Rouge, LA 70808-9143
Phone (225) 769-0933

Other identifiers 1

IdentifierTypeStateIssuer
1624781MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
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
I20110511000372 TX Practitioner - Physician Assistant 8820180458 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
A10230LAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
East Texas Surgical Associates, PA Past Accepting new patients
Charles J. Rodman, MD PA Past Accepting new patients

Organizations & group practices 3

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": "1134518400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208476800000",
    "number": "1659356301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5231 BRITTANY DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089143",
            "telephone_number": "225-769-0933",
            "fax_number": "225-769-5008"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5231 BRITTANY DR",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708089143",
            "telephone_number": "225-769-0933",
            "fax_number": "225-769-5008"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUSELIER",
        "first_name": "VICTOR",
        "middle_name": "WAYNE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-14",
        "last_updated": "2008-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "LA",
            "license": "A10230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1624781",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.