NPIMap

Organization Active NPI

Iberia Gastroenterology Associates, Inc. a Professional Medical Corpor

  • Gastroenterology Physician
  • New Iberia, LA
National Provider Identifier
1962526509
Registry record updated Jul 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
IBERIA GASTROENTEROLOGY ASSOCIATES, INC. A PROFESSIONAL MEDICAL CORPOR
Practice address
2309 E Main St Ste 101
New Iberia, LA 70560-4063
Phone
(337) 364-3301
Fax
(337) 364-9689
NPI assigned
Mar 19, 2007
Last updated
Jul 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 11, 2019

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

Authorized official

Name
Son V. Nguyen Jr., MDNPI 1881874899
Title
Ceo
Phone
(337) 364-3301

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
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

2309 E Main St Ste 101
New Iberia, LA 70560-4063

Mailing address

2309 E Main St Ste 101
New Iberia, LA 70560-4063
Phone (337) 364-3301

Other practice location 1

220 North Rd
Erath, LA 70533-3200
Phone (337) 364-3301

Other identifiers 1

IdentifierTypeStateIssuer
1949566MedicaidLA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100106000687 LA Part B Supplier - Clinic/Group Practice 0648238014 Receives reassigned benefits from 3 practitioners
Practice locations: Broussard, LA; New Iberia, 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
19D2318687Iberia Gastroenterology Associates2309 E Main St, Suite 101, New Iberia, LA 70560Certificate of waiverFeb 13, 2027

National Provider Directory

National Provider Directory

Locations

803 Albertson Pkwy
Broussard, LA 70518
Phone (337) 364-3301

516 Jefferson Ter
New Iberia, LA 70560
Phone (337) 201-1630

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/HFDFBA

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1562803200000",
    "number": "1962526509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 E MAIN ST STE 101",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705604063",
            "telephone_number": "337-364-3301",
            "fax_number": "337-364-9689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 E MAIN ST STE 101",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705604063",
            "telephone_number": "337-364-3301",
            "fax_number": "337-364-9689"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "220 North Rd",
            "address_purpose": "LOCATION",
            "city": "Erath",
            "state": "LA",
            "postal_code": "705333200",
            "country_code": "US",
            "telephone_number": "337-364-3301",
            "fax_number": "337-364-3301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IBERIA GASTROENTEROLOGY ASSOCIATES, INC. A PROFESSIONAL MEDICAL CORPOR",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2019-07-11",
        "status": "A",
        "authorized_official_last_name": "NGUYEN",
        "authorized_official_first_name": "SON",
        "authorized_official_middle_name": "V.",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "337-364-3301",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1949566",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2019; 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.