Individual provider Active NPI

Brett Bankston, PA-C

  • Physician Assistant
  • Baton Rouge, LA
National Provider Identifier
1831932243
Registry record updated Jun 14, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
1197616 Issued in LA
Practice address
8888 Summa Ave FL 3
Baton Rouge, LA 70809-3772
Phone
(225) 763-4000
NPI assigned
Jun 13, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2024

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 1197616 LA Primary

Addresses

Primary practice location

8888 Summa Ave FL 3
Baton Rouge, LA 70809-3772

Mailing address

18023 Old Trail Dr
Prairieville, LA 70769-5586
Phone (225) 276-3618

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
I20240910003107 LA Practitioner - Physician Assistant 0345780946 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
New Orleans Physician Services IncGroup PAC ID 5294057824, 177 clinicians

Practice addresses (Care Compare)

4513 Westbank Expressway
Marrero, LA 70072
Phone (504) 349-6360

Hospital & facility affiliations

  • East Jefferson General Hospital Hospital, Metairie, LA, CCN 190176
  • North Oaks Medical Center Hospital, Hammond, LA, CCN 190015

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1197616LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
University Medical Center Management Corporation CurrentSince Aug 29, 2024 Accepting new patients

Locations

2000 Canal St
New Orleans, LA 70112
Phone (504) 702-2287

Organizations & group practices 3

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": "1718236800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1831932243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18023 OLD TRAIL DR",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707695586",
            "telephone_number": "225-276-3618"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8888 SUMMA AVE FL 3",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093772",
            "telephone_number": "225-763-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BANKSTON",
        "first_name": "BRETT",
        "name_prefix": "Mr.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-13",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "1197616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.