Jorge Rafael Belgodere-Bonilla, MD
Individual provider Active NPI Internal Medicine Physician · Broussard, LA
NPI 1841306255 · NPPES record last updated Sep 12, 2022
Key facts
- NPI
- 1841306255
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Internal Medicine Physician 207R00000X
- License
- MD025916 (LA)
- Practice address
- 811 Albertson Pkwy Ste F
Broussard, LA 70518-5256 - Phone
- (337) 837-3615
- Fax
- (337) 839-8097
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 7
Hospital & facility affiliations 8
Medicare Care Compare profile
- Specialty
- Internal Medicine
- Education
- Louisiana State University School of Medicine in New Orleans, 1987
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
811 Albertson Pkwy
Suite F
Broussard, LA 70518-5256
Phone (337) 837-3615
Hospital & facility affiliations
- Audubon Home Health of Lafayette
- Lourdes Home Health
- Acadian Homecare, LLC
- Our Lady of Lourdes Regional Medical Center, Inc
- Ochsner Lafayette General Medical Center
- Park Place Surgical Hospital
- Lafayette-Amg Physical Rehabilitation Hospital
- Lafayette - a M G Specialty Hospital
Merit-based Incentive Payment System (MIPS)
- Final score
- 75 of 100
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Removal of tissue | 13 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20051122000554 | LA | Practitioner - Internal Medicine | 7113972605 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD025916 | LA | MD | Internal Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bryant Medical Group LLC | Current |
Accepting new patients | |
| Youngsville Medical Clinic | Internal Medicine | Current |
Accepting new patients |
| Stephen W. Darbonne, LLC | Internal Medicine | Past | Accepting new patients |
| Ladebe LLC | Internal Medicine | Past | Accepting new patients |
| Youngsville Medical LLC | Past | Accepting new patients | |
| Our Lady of Lourdes Regional Medical Center, Inc | Past | Accepting new patients | |
| Southern Louisiana Rehab LLC | Past | Accepting new patients |
Locations
811 Albertson Pkwy
Ste F
Broussard, LA 70518
Phone (337) 330-2386
310A Youngsville Hwy
Lafayette, LA 70508
Phone (337) 837-3615
314 Youngsville Hwy
#A
Lafayette, LA 70508
Phone (337) 269-9566
4801 Ambassador Caffery Pkwy
Lafayette, LA 70508
Phone (337) 470-2000
208 Rue Louis Xiv
Lafayette, LA 70508
Phone (337) 504-5885
800 W Main St
New Iberia, LA 70560
Phone (337) 367-2567
Interoperability endpoints
- https://fhir4.healow.com/fhir/r4/IBCJCD/Endpoint/IBCJCD
- https://fhir4.healow.com/fhir/r4/IBCJCD
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | MD025916 | LA | Yes |
Addresses
Primary practice location
811 Albertson Pkwy Ste F
Broussard, LA 70518-5256
Mailing address
811 Albertson Pkwy Ste F
Broussard, LA 70518-5256
Phone (337) 837-3615
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 5CS48 | Other | LA | MEDICARE |
| 1545619 | Medicaid | LA |
Other providers in Broussard, LA
- Assured Medical,Inc
- Kyle Babin
- Ariel Babineaux
- Melanie Baker Russo
- Kristian Dawn Barbay
- Victoria Ann Bell
- Michelle Lee Benoit
- David Joseph Bernard
- Terry Peterson Berniard
- John Austin Berry
All providers in Broussard, LA · Internal Medicine Physician in Louisiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 12, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.