NPIMap

Individual provider Active NPI

Shayne M Brizzard, PAC

  • Surgical Physician Assistant
  • Baton Rouge, LA
National Provider Identifier
1841371150
Registry record updated Mar 28, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgical Physician AssistantTaxonomy code 363AS0400X
License
A10365 Issued in LA
Practice address
10101 Park Rowe Ave Ste 200
Baton Rouge, LA 70810-1685
Phone
(225) 769-2200
Fax
(225) 768-2185
NPI assigned
Oct 17, 2006
Last updated
Mar 28, 2008By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 28, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X A10365 LA Primary

Addresses

Primary practice location

10101 Park Rowe Ave Ste 200
Baton Rouge, LA 70810-1685

Mailing address

PO Box 98509
Baton Rouge, LA 70884-9509
Phone (225) 769-2200

Other identifiers 1

IdentifierTypeStateIssuer
1626473MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060327000012 LA Practitioner - Physician Assistant 6901706803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Neuromedical CenterGroup PAC ID 6103716477, 114 clinicians

Practice addresses (Care Compare)

10101 Park Rowe Ave
Suite 200
Baton Rouge, LA 70810-1685
Phone 22576922002164

19065 Dr John Lambert Dr
Suite 2900
Hammond, LA 70403-1046
Phone (225) 769-2200

5000 Hennessy Blvd
Baton Rouge, LA 70808-4375
Phone (225) 765-6565

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
83.93 of 100Reported as group
Quality
71.55
Promoting interoperability
100
Improvement activities
40
Cost
74.88

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
A10365LAMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vascular Specialty Associates Past Accepting new patients
Vascular Associates Laboratory Past Accepting new patients

Interoperability endpoints

  • Direct secure messaging: shayne.brizzard.1@25776.direct.athenahealth.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 23

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1161043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206662400000",
    "number": "1841371150",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 98509",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708849509",
            "telephone_number": "225-769-2200",
            "fax_number": "225-768-2185"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10101 PARK ROWE AVE STE 200",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101685",
            "telephone_number": "225-769-2200",
            "fax_number": "225-768-2185"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIZZARD",
        "first_name": "SHAYNE",
        "middle_name": "M",
        "credential": "PAC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-17",
        "last_updated": "2008-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "LA",
            "license": "A10365",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1626473",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.