Individual provider Active NPI

Manikandan Nagendran, MD

  • Internal Medicine Physician
  • Lafayette, LA
National Provider Identifier
1730398801
Registry record updated Sep 5, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD.202135 Issued in LA
Practice address
2390 W Congress St
Quality Management Dept
Lafayette, LA 70506-4205
Phone
(337) 261-6323
Fax
(337) 261-6334
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD.202135 LA Primary

Addresses

Primary practice location

2390 W Congress St
Quality Management Dept
Lafayette, LA 70506-4205

Mailing address

2390 W Congress St
Quality Management Dept
Lafayette, LA 70506-4205
Phone (337) 261-6323

Other practice location 1

425 Settlers Trace Blvd Ste 200
Lafayette, LA 70508-6048
Phone (337) 735-8500

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
I20090122000314 LA Practitioner - Internal Medicine 5698839470 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Coolidge Physician Services LLCGroup PAC ID 7113156035, 52 clinicians

Practice addresses (Care Compare)

1214 Coolidge Blvd
Lafayette, LA 70503-2621
Phone (337) 289-7991

Hospital & facility affiliations

  • Acadian Homecare, LLC Home health agency, Lafayette, LA, CCN 197060
  • Acadian Homecare of New Iberia, LLC Home health agency, New Iberia, LA, CCN 197718
  • Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002
  • Our Lady of Lourdes Regional Medical Center, Inc Hospital, Lafayette, LA, CCN 190102
  • Ochsner St Martin Hospital Hospital, Breaux Bridge, LA, CCN 191302

Merit-based Incentive Payment System (MIPS)

Final score
86.29 of 100Reported as group
Quality
72.11
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Opelousas Physician Services LLC CurrentSince Jul 1, 2013 Accepting new patients
Ambassador Physician Services LLC CurrentSince Nov 7, 2008 Accepting new patients
Hub City Physician Group, LLC CurrentSince Oct 1, 2015 Accepting new patients
Coolidge Physician Services LLC CurrentSince Feb 10, 2014 Accepting new patients
Main Street Physician Services LLC CurrentSince Dec 1, 2014 Accepting new patients
Lafayette General Medical Center Inc Past Accepting new patients
Alvin C Moreau Jr Licensed Physical Therapist DTD 01 15 82 PastSince Sep 9, 2019 Accepting new patients

Locations

1305 E Highway 90
Crowley, LA 70526
Phone (337) 783-3222

310 Youngsville Hwy
Lafayette, LA 70508
Phone (337) 837-5250

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

4600 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 371-3135

2315 E Main St
Fl 3
New Iberia, LA 70560
Phone (337) 369-1100

600 N Lewis St
New Iberia, LA 70563
Phone (337) 365-7311

539 E Prudhomme St
Opelousas, LA 70570
Phone (337) 943-7128

Interoperability endpoints

  • Direct secure messaging: mnagendran1452575@direct.ochsner.org

Organizations & group practices 8

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 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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567641600000",
    "number": "1730398801",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2390 W CONGRESS ST",
            "address_2": "QUALITY MANAGEMENT DEPT",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064205",
            "telephone_number": "337-261-6323",
            "fax_number": "337-261-6334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2390 W CONGRESS ST",
            "address_2": "QUALITY MANAGEMENT DEPT",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705064205",
            "telephone_number": "337-261-6323",
            "fax_number": "337-261-6334"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "425 Settlers Trace Blvd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705086048",
            "country_code": "US",
            "telephone_number": "337-735-8500",
            "fax_number": "337-735-8501",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NAGENDRAN",
        "first_name": "MANIKANDAN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2019-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "MD.202135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, LA

Sources for this page

Verify at the official NPI Registry.