Individual provider Active NPI

Amanda J Hayes, NP

  • Nurse Practitioner
  • Breaux Bridge, LA
National Provider Identifier
1811292584
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP06127 Issued in LA
Practice address
548 Lakes Blvd
Breaux Bridge, LA 70517
Phone
(337) 332-0661
NPI assigned
Jan 11, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP06127 LA Primary

Addresses

Primary practice location

548 Lakes Blvd
Breaux Bridge, LA 70517

Mailing address

548 Lakes Blvd
Breaux Bridge, LA 70517-3240
Phone (337) 332-0661

Other practice location 1

3521 Highway 190
Suite S
Eunice, LA 70535-5135
Phone (337) 550-8530

Other practice location 2

3521 Highway 190
Suite S
Eunice, LA 70535-5135
Phone (337) 550-8530

Electronic endpoints 2

TypeEndpointUseAffiliation
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other
Direct Messaging Address ahayes14647@direct.casso.us.com Direct

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110314000358 LA Practitioner - Nurse Practitioner 7517149446 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Acadiana Renal Physicians AMCGroup PAC ID 5890783070, 16 clinicians
Lourdes Physician Group LLCGroup PAC ID 7214177757, 157 clinicians

Practice addresses (Care Compare)

300 W Saint Mary Blvd
Lafayette, LA 70506-4638
Phone (337) 233-6593

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508-6917
Phone (337) 470-2990

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP06127LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lourdes Physician Group LLC Nurse Practitioner CurrentSince Apr 8, 2019 Accepting new patients
Acadiana Renal Physicians AMC CurrentSince Feb 24, 2015 Accepting new patients

Locations

548 Lakes Blvd
Breaux Bridge, LA 70517
Phone (337) 332-0661

4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000

300 W Saint Mary Blvd
Lafayette, LA 70506
Phone (337) 233-1542

3220 Kaliste Saloom Rd
Lafayette, LA 70508
Phone (337) 406-9474

4525 Ambassador Caffery Pkwy
Lafayette, LA 70508

Interoperability endpoints

  • Direct secure messaging: ahayes14647@direct.casso.us.com
  • Direct secure messaging: ahayes21192@direct.acumenmd.com

Organizations & group practices 2

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": "1294704000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1811292584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "548 LAKES BLVD",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705173240",
            "telephone_number": "337-332-0661",
            "fax_number": "337-332-0651"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 LAKES BLVD",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "70517",
            "telephone_number": "337-332-0661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3521 Highway 190",
            "address_2": "Suite S",
            "address_purpose": "LOCATION",
            "city": "Eunice",
            "state": "LA",
            "postal_code": "705355135",
            "country_code": "US",
            "telephone_number": "337-550-8530",
            "fax_number": "337-550-8534",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3521 Highway 190",
            "address_2": "Suite S",
            "address_purpose": "LOCATION",
            "city": "Eunice",
            "state": "LA",
            "postal_code": "705355135",
            "country_code": "US",
            "telephone_number": "337-550-8530",
            "fax_number": "337-550-8534",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAYES",
        "first_name": "AMANDA",
        "middle_name": "J",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-01-11",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "AP06127",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "548 Lakes Blvd",
            "city": "Breaux Bridge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70517",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ahayes14647@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "ahayes14647@direct.casso.us.com",
            "address_1": "548 Lakes Blvd",
            "city": "Breaux Bridge",
            "state": "LA",
            "country_code": "US",
            "postal_code": "70517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Breaux Bridge, LA

Sources for this page

Verify at the official NPI Registry.