NPIMap

Organization Active NPI

Palliative Medicine of Acadiana

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Lafayette, LA
National Provider Identifier
1780148197
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Family Medicine) PhysicianTaxonomy code 207QH0002X
Legal business name
PALLIATIVE MEDICINE OF ACADIANA
Practice address
2600 Johnston St Ste 260
Lafayette, LA 70503-3269
Phone
(337) 232-1234
Fax
(337) 232-0477
NPI assigned
Jan 30, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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

Authorized official

Name
Stacy Mistric
Title
Ceo
Phone
(337) 889-5364

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Family Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207QH0002X Primary

Addresses

Primary practice location

2600 Johnston St Ste 260
Lafayette, LA 70503-3269

Mailing address

2600 Johnston St Ste 260
Lafayette, LA 70503-3269
Phone (337) 232-1234

Other practice location 1

803 Albertson Pkwy Ste B
Broussard, LA 70518-4349
Phone (337) 889-5364

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20191106002962 LA Part B Supplier - Clinic/Group Practice 6103258496 Receives reassigned benefits from 7 practitioners
Practice locations: Broussard, LA; Lafayette, LA

National Provider Directory

National Provider Directory

Locations

805 Albertson Pkwy
Ste B
Broussard, LA 70518
Phone (337) 324-3031

803 Albertson Pkwy
Ste B
Broussard, LA 70518
Phone (337) 232-1234

2600 Johnston St
Ste 260
Lafayette, LA 70503
Phone (337) 889-5364

2600 Johnston St
Ste 200
Lafayette, LA 70503
Phone (337) 232-1234

2600 Johnston St
Ste 20
Lafayette, LA 70503

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1548806400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762387200000",
    "number": "1780148197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 JOHNSTON ST STE 260",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033269",
            "telephone_number": "337-232-1234",
            "fax_number": "337-232-0477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 JOHNSTON ST STE 260",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705033269",
            "telephone_number": "337-232-1234",
            "fax_number": "337-232-0477"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "803 Albertson Pkwy Ste B",
            "address_purpose": "LOCATION",
            "city": "Broussard",
            "state": "LA",
            "postal_code": "705184349",
            "country_code": "US",
            "telephone_number": "337-889-5364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PALLIATIVE MEDICINE OF ACADIANA",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-01-30",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A",
        "authorized_official_last_name": "MISTRIC",
        "authorized_official_first_name": "STACY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-889-5364"
    },
    "taxonomies": [
        {
            "code": "207QH0002X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.