Organization Active NPI

Thibodaux Endoscopy LLC

  • Ambulatory Surgical Clinic/Center
  • Thibodaux, LA
National Provider Identifier
1831167329
Registry record updated Apr 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
0112 Issued in LA
Legal business name
THIBODAUX ENDOSCOPY LLC
Practice address
764 N Acadia Rd Ste B
Thibodaux, LA 70301-5009
Phone
(985) 446-1958
Fax
(985) 446-0121
NPI assigned
Mar 9, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 28, 2025

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

Authorized official

Name
Charles J Monier Jr., MDNPI 1043288160
Title
President
Phone
(985) 446-1958

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 0112 LA Primary

Addresses

Primary practice location

764 N Acadia Rd Ste B
Thibodaux, LA 70301-5009

Mailing address

764 N Acadia Rd Ste B
Thibodaux, LA 70301-5009
Phone (985) 446-1958

Other identifiers 1

IdentifierTypeStateIssuer
1167452MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100113000076 LA Part B Supplier - Ambulatory Surgical Center 6406997451 Practice locations: Thibodaux, LA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Thibodaux Endoscopy LLCCCN 19C0001082
Medicare certification status
ActiveFrom the Provider of Services file

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2240433Thibodaux Endoscopy LLC764 N Acadia Rd, Ste B, Thibodaux, LA 70301Certificate of waiverOct 18, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1141862400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745798400000",
    "number": "1831167329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "764 N ACADIA RD STE B",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015009",
            "telephone_number": "985-446-1958",
            "fax_number": "985-446-0121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "764 N ACADIA RD STE B",
            "city": "THIBODAUX",
            "state": "LA",
            "postal_code": "703015009",
            "telephone_number": "985-446-1958",
            "fax_number": "985-446-0121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THIBODAUX ENDOSCOPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-09",
        "last_updated": "2025-04-28",
        "certification_date": "2025-04-28",
        "status": "A",
        "authorized_official_last_name": "MONIER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-446-1958",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "LA",
            "license": "0112",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1167452",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thibodaux, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.