Organization Active NPI

Acadiana Otolaryngology Head and Neck Surgery LLC

  • Otolaryngology Physician
  • Lafayette, LA
National Provider Identifier
1861453201
Registry record updated Aug 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology PhysicianTaxonomy code 207Y00000X
Legal business name
ACADIANA OTOLARYNGOLOGY HEAD AND NECK SURGERY LLC
Practice address
4212 W Congress St Ste 1500
Lafayette, LA 70506-6767
Phone
(337) 981-6464
Fax
(337) 981-6440
NPI assigned
Mar 28, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2024

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

Authorized official

Name
Dr. Robin J Barry, MDNPI 1750350427
Title
Managing Partner
Phone
(337) 981-6464

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Y00000X Primary

Addresses

Primary practice location

4212 W Congress St Ste 1500
Lafayette, LA 70506-6767

Mailing address

PO Box 52068
Lafayette, LA 70505-2068
Phone (337) 981-6464

Other practice location 1

105 Patriot St Ste 204
Lafayette, LA 70508-6831
Phone (337) 456-1106

Other identifiers 1

IdentifierTypeStateIssuer
1945960MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031229000199 LA Part B Supplier - Clinic/Group Practice 7214835305 Receives reassigned benefits from 4 practitioners
Practice locations: Lafayette, LA

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

1039 Camellia Blvd
Lafayette, LA 70508
Phone (337) 237-0650

1103 Kaliste Saloom Rd
Ste 300
Lafayette, LA 70508
Phone (337) 456-3282

105 Patriot St
Ste 204
Lafayette, LA 70508
Phone (337) 456-1106

515 S College Rd
Ste 255
Lafayette, LA 70503
Phone (337) 233-7174

4809 Ambassador Caffery Pkwy
Ste 260
Lafayette, LA 70508
Phone (337) 436-8029

1700 Kaliste Saloom Rd
Bldg 100B
Lafayette, LA 70508
Phone (337) 210-2098

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1723334400000",
    "number": "1861453201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52068",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705052068",
            "telephone_number": "337-981-6464",
            "fax_number": "337-981-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4212 W CONGRESS ST STE 1500",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705066767",
            "telephone_number": "337-981-6464",
            "fax_number": "337-981-6440"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "105 Patriot St Ste 204",
            "address_purpose": "LOCATION",
            "city": "Lafayette",
            "state": "LA",
            "postal_code": "705086831",
            "country_code": "US",
            "telephone_number": "337-456-1106",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ACADIANA OTOLARYNGOLOGY HEAD AND NECK SURGERY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-28",
        "last_updated": "2024-08-11",
        "certification_date": "2024-08-11",
        "status": "A",
        "authorized_official_last_name": "BARRY",
        "authorized_official_first_name": "ROBIN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "337-981-6464",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Y00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Otolaryngology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1945960",
            "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 Aug 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.