NPIMap

Individual provider Active NPI

Jason Brian Fuqua, M.D.

  • Family Medicine Physician
  • Sulphur, LA
National Provider Identifier
1700051133
Registry record updated Oct 13, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
MD.201762 Issued in LA
Practice address
920 1St Ave
Sulphur, LA 70663-3425
Phone
(337) 528-7472
Fax
(337) 528-7457
NPI assigned
Apr 27, 2008
Last updated
Oct 13, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 13, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X MD.201762 LA Primary

Addresses

Primary practice location

920 1St Ave
Sulphur, LA 70663-3425

Mailing address

920 1St Ave
Sulphur, LA 70663-3425
Phone (337) 528-7472

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090626000017 LA Practitioner - Family Practice 1052462322 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

701 Cypress St
Sulphur, LA 70663-5053
Phone (337) 527-6530

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Calcasieu Cameron Hospital Service District CurrentSince Sep 28, 2013 Accepting new patients
Calcasieu Cameron Hospital Service District Family Medicine CurrentSince Sep 28, 2013 Accepting new patients
Heart of Hospice LLC Family Medicine Past Accepting new patients
Calcasieu Cameron Hospital Service District Family Medicine Past Accepting new patients

Locations

6240 Gulf Beach Hwy
Cameron, LA 70631
Phone (337) 527-6530

1020 Main St
Hackberry, LA 70645
Phone (337) 762-3762

151 Walker Rd
Sulphur, LA 70665
Phone (337) 528-7472

701 Cypress St
Sulphur, LA 70663
Phone (337) 527-4270

920 1st Ave
Sulphur, LA 70663
Phone (337) 527-6301

Organizations & group practices 4

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 14

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1209254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350086400000",
    "number": "1700051133",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 1ST AVE",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706633425",
            "telephone_number": "337-528-7472",
            "fax_number": "337-528-7457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 1ST AVE",
            "city": "SULPHUR",
            "state": "LA",
            "postal_code": "706633425",
            "telephone_number": "337-528-7472",
            "fax_number": "337-528-7457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "JASON",
        "middle_name": "BRIAN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-04-27",
        "last_updated": "2012-10-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "MD.201762",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sulphur, LA

Sources for this page

Verify at the official NPI Registry.