Individual provider Active NPI

Riley Bordelon, PA

  • Physician Assistant
  • Baton Rouge, LA
National Provider Identifier
1740112978
Registry record updated Jun 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
10101 Park Rowe Ave FL 1-4
Baton Rouge, LA 70810-1686
Phone
(225) 769-2200
NPI assigned
Jun 2, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X LA Primary

Addresses

Primary practice location

10101 Park Rowe Ave FL 1-4
Baton Rouge, LA 70810-1686

Mailing address

8886 BMG Dr
Maringouin, LA 70757-5325

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
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.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1780358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780358400000",
    "number": "1740112978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8886 BMG DR",
            "city": "MARINGOUIN",
            "state": "LA",
            "postal_code": "707575325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 PARK ROWE AVE FL 1-4",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101686",
            "telephone_number": "225-769-2200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BORDELON",
        "first_name": "RILEY",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-06-02",
        "last_updated": "2026-06-02",
        "certification_date": "2026-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.