NPIMap

Individual provider Active NPI

Jeffrey John Daigle, P.A.

  • Physician Assistant
  • Lake Charles, LA
National Provider Identifier
1740577998
Registry record updated Dec 27, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA200462 Issued in LA
Practice address
1615 Wolf Cir
Lake Charles, LA 70605-2348
Phone
(337) 312-8681
Fax
(337) 312-8682
NPI assigned
Jul 7, 2011
Last updated
Dec 27, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 27, 2019

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 PA200462 LA Primary

Addresses

Primary practice location

1615 Wolf Cir
Lake Charles, LA 70605-2348

Mailing address

501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 312-8258

Other identifiers 1

IdentifierTypeStateIssuer
2161113MedicaidLA

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
I20111004000194 LA Practitioner - Physician Assistant 1850563461 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imperial Health LLPGroup PAC ID 7719886779, 75 clinicians
Lake Charles Urgent CareGroup PAC ID 1052580644, 14 clinicians
Lcuc Family Physicians Urgent Care LLCGroup PAC ID 8325327935, 13 clinicians

Practice addresses (Care Compare)

1615 Wolf Circle
Lake Charles, LA 70605-2348
Phone (337) 312-8564

1905 Country Club Rd
Lake Charles, LA 70605-5203
Phone (337) 990-8000

2400 Ryan St
Lake Charles, LA 70601-7322
Phone (337) 433-1260

301 S Cities Service Hwy
Sulphur, LA 70663-6405
Phone (337) 888-3171

501 Doctor Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 433-8400

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA200462LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Lake Charles Primary Care and Wellness CurrentSince Aug 8, 2025 Accepting new patients
LCMS Ear, Nose and Throat Clinic of Southwest Louisiana, LLC Past Accepting new patients

Locations

1905 Country Club Rd
Lake Charles, LA 70605
Phone (337) 990-8000

1905 Country Club Rd
Ste B
Lake Charles, LA 70605
Phone (337) 990-8002

Interoperability endpoints

  • Direct secure messaging: jeffrey.daigle@1288.direct.myezyaccess.com

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 7

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": "1309996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577404800000",
    "number": "1740577998",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015724",
            "telephone_number": "337-312-8258",
            "fax_number": "337-312-6708"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1615 WOLF CIR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706052348",
            "telephone_number": "337-312-8681",
            "fax_number": "337-312-8682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAIGLE",
        "first_name": "JEFFREY",
        "middle_name": "JOHN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-07",
        "last_updated": "2019-12-27",
        "certification_date": "2019-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA200462",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2161113",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.