NPIMap

Organization Active NPI

Anesthesiology & Pain Consultants, LLC

  • Anesthesiology Physician
  • Lafayette, LA
National Provider Identifier
1841287901
Registry record updated Feb 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
Legal business name
ANESTHESIOLOGY & PAIN CONSULTANTS, LLC
Practice address
1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5783
Phone
(337) 988-5646
Fax
(337) 988-4298
NPI assigned
Oct 4, 2005
Last updated
Feb 8, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2018

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

Authorized official

Name
Mrs. Crystal Broussard
Title
Credentialing Coordinator
Phone
(337) 706-1545

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X NU Primary

Addresses

Primary practice location

1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5783

Mailing address

1103 Kaliste Saloom Rd
Suite 304
Lafayette, LA 70508-5783
Phone (337) 988-5646

Other identifiers 1

IdentifierTypeStateIssuer
1949621MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031212000737 LA Part B Supplier - Clinic/Group Practice 3870490402 Receives reassigned benefits from 87 practitioners
Practice locations: Lafayette, LA

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
19D1096121Anesthesiology & Pain Consultants1103 Kaliste Saloom Road Suite 304, Lafayette, LA 70508AccreditationJan 10, 2028

National Provider Directory

National Provider Directory

Locations

4212 W Congress St
Ste 1401
Lafayette, LA 70506
Phone (337) 416-4198

4212 W Congress St
Ste 3200
Lafayette, LA 70506
Phone (337) 273-2863

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 87

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 87

NPI Registry JSON

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

{
    "created_epoch": "1128384000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1518048000000",
    "number": "1841287901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 KALISTE SALOOM RD",
            "address_2": "SUITE 304",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085783",
            "telephone_number": "337-988-5646",
            "fax_number": "337-988-4298"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 KALISTE SALOOM RD",
            "address_2": "SUITE 304",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705085783",
            "telephone_number": "337-988-5646",
            "fax_number": "337-988-4298"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ANESTHESIOLOGY & PAIN CONSULTANTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-04",
        "last_updated": "2018-02-08",
        "status": "A",
        "authorized_official_last_name": "BROUSSARD",
        "authorized_official_first_name": "CRYSTAL",
        "authorized_official_title_or_position": "CREDENTIALING COORDINATOR",
        "authorized_official_telephone_number": "337-706-1545",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1949621",
            "state": "LA"
        }
    ],
    "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 Feb 8, 2018; 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.