Individual provider Active NPI

Raymond Pesson, CRNA

  • Certified Registered Nurse Anesthetist
  • Lafayette, LA
National Provider Identifier
1699750950
Registry record updated Aug 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
AP03882 Issued in LA
Practice address
1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5783
Phone
(337) 988-5646
Fax
(337) 988-4298
NPI assigned
Dec 9, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X AP03882 LA Primary

Addresses

Primary practice location

1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5783

Mailing address

1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5783
Phone (337) 988-5646

Other identifiers 1

IdentifierTypeStateIssuer
1187208MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110504000022 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 7113102302 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Youngs Professional Services LLCGroup PAC ID 2163524992, 297 clinicians

Practice addresses (Care Compare)

443 Heymann Blvd
Lafayette, LA 70503-2630
Phone (337) 269-1126

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
AP03882LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Youngs Professional Services LLC Nurse Anesthetist, Certified Registered CurrentSince Jun 1, 2024 Accepting new patients
Precision Anesthesia of Lafayette LLC Nurse Anesthetist, Certified Registered CurrentSince Apr 1, 2019 Accepting new patients
Anesthesiology & Pain Consultants, LLC CurrentSince Jun 1, 2001 Accepting new patients
DRS Burleigh, Dupleix and Rees Past Accepting new patients
Twin City Anesthesia Past Accepting new patients

Locations

1103 Kaliste Saloom Rd
Ste 304
Lafayette, LA 70508
Phone (318) 981-3546

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

443 Heymann Blvd
Lafayette, LA 70503
Phone (337) 269-1126

1211 Coolidge Blvd
Lafayette, LA 70503
Phone (337) 234-9191

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

Interoperability endpoints

  • FHIR API: https://fhir.meditouchehr.com/api/fhir/r4/

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1134086400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280707200000",
    "number": "1699750950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 KALISTE SALOOM RD",
            "address_2": "SUITE 304",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085783",
            "telephone_number": "337-988-5646",
            "fax_number": "337-988-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 KALISTE SALOOM RD",
            "address_2": "SUITE 304",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085783",
            "telephone_number": "337-988-5646",
            "fax_number": "337-988-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PESSON",
        "first_name": "RAYMOND",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-09",
        "last_updated": "2010-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "AP03882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1187208",
            "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 Aug 2, 2010; 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.