Individual provider Active NPI

Michael David Marceaux, C.R.N.A.

  • Certified Registered Nurse Anesthetist
  • Jennings, LA
National Provider Identifier
1861422610
Registry record updated Apr 26, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
49835 Issued in LA
Practice address
1634 Elton Rd
Jennings, LA 70546-3614
Phone
(225) 923-0030
Fax
(225) 923-0060
NPI assigned
Jul 4, 2006
Last updated
Apr 26, 2016By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 49835 LA Primary

Addresses

Primary practice location

1634 Elton Rd
Jennings, LA 70546-3614

Mailing address

PO Box 14447
Baton Rouge, LA 70898-4447
Phone (225) 923-0030

Other identifiers 1

IdentifierTypeStateIssuer
1699560MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070129000448 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254332570 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lafayette Health Ventures IncGroup PAC ID 9335043074, 299 clinicians

Practice addresses (Care Compare)

1634 Elton Rd
Jennings American Legion Hospital Crna
Jennings, LA 70546-3614
Phone (337) 571-1396

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
49835LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Lafayette Health Ventures Inc CurrentSince Jan 22, 2023 Accepting new patients
Lafayette Health Ventures Inc Current Accepting new patients
Lafayette Health Ventures, Inc CurrentSince Jan 22, 2023 Accepting new patients
Primary Anesthesia Services Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

1634 Elton Rd
Jennings, LA 70546
Phone (337) 616-7000

4212 W Congress St
Ste 3100
Lafayette, LA 70506
Phone (337) 703-3201

Organizations & group practices 5

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 1

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": "1151971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1461628800000",
    "number": "1861422610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 14447",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708984447",
            "telephone_number": "225-923-0030",
            "fax_number": "225-923-0060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1634 ELTON RD",
            "city": "JENNINGS",
            "state": "LA",
            "postal_code": "705463614",
            "telephone_number": "225-923-0030",
            "fax_number": "225-923-0060"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCEAUX",
        "first_name": "MICHAEL",
        "middle_name": "DAVID",
        "credential": "C.R.N.A.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-04",
        "last_updated": "2016-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "49835",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1699560",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jennings, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2016; 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.