Individual provider Active NPI

John-Mario Walter Altamirano, FNP

  • Nurse Practitioner
  • Lafayette, LA
National Provider Identifier
1659764041
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP08184 Issued in LA
Practice address
2730 Ambassador Caffery Pkwy
Lafayette, LA 70506-5939
Phone
(337) 988-1585
Fax
(337) 981-4694
NPI assigned
Mar 10, 2015
Last updated
Jan 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP08184 LA Primary

Addresses

Primary practice location

2730 Ambassador Caffery Pkwy
Lafayette, LA 70506-5939

Mailing address

2730 Ambassador Caffery Pkwy
Lafayette, LA 70506-5939
Phone (337) 988-1585

Other identifiers 1

IdentifierTypeStateIssuer
2387022MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, MS2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20150521000130 LA Practitioner - Nurse Practitioner 8729308457 Reassigns benefits to 3 organizations
I20200915001265 MS Practitioner - Nurse Practitioner 8729308457 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Cardiovascular Institute of the South, LLCGroup PAC ID 3779497441, 145 clinicians

Practice addresses (Care Compare)

2730 Ambassador Caffery Pkwy
Lafayette, LA 70506-5939
Phone (337) 988-1585

4909 Great River Dr
Meridian, MS 39305-2664
Phone (601) 282-8980

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP08184LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lsuhn Billing LLC CurrentSince May 11, 2015 Accepting new patients
University Hospital & Clinics, Inc. CurrentSince May 11, 2015 Accepting new patients
University Hospital & Clinics Inc CurrentSince May 11, 2015 Accepting new patients
Lsuhn Billing LLC CurrentSince May 11, 2015 Accepting new patients

Locations

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

Interoperability endpoints

  • Direct secure messaging: jaltamirano883060@direct.ochsner.org

Organizations & group practices 5

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.

Hospital & facility affiliations 5

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": "1425945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579478400000",
    "number": "1659764041",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2730 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705065939",
            "telephone_number": "337-988-1585",
            "fax_number": "337-981-4694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2730 AMBASSADOR CAFFERY PKWY",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705065939",
            "telephone_number": "337-988-1585",
            "fax_number": "337-981-4694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTAMIRANO",
        "first_name": "JOHN-MARIO",
        "middle_name": "WALTER",
        "credential": "FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-03-10",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP08184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2387022",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.