Individual provider Active NPI

Matthew Stephen Latiolais, P.A.

  • Physician Assistant
  • Baton Rouge, LA
National Provider Identifier
1992989941
Registry record updated Mar 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA.200141 Issued in LA
Practice address
12525 Perkins Rd
Baton Rouge, LA 70810-1907
Phone
(225) 819-8857
Fax
(225) 767-6822
NPI assigned
Dec 27, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X PA.200141 LA Primary

Addresses

Primary practice location

12525 Perkins Rd
Baton Rouge, LA 70810-1907

Mailing address

7777 Hennessy Blvd
Suite 1004-154
Baton Rouge, LA 70808-4300
Phone (225) 214-9352

Other identifiers 1

IdentifierTypeStateIssuer
1027839MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080122000751 LA Practitioner - Physician Assistant 4880775329 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2007
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)

1216 Camellia Blvd
Lafayette, LA 70508-6667
Phone (337) 769-0069

2810 Bonin Rd
Youngsville, LA 70592-5600
Phone (337) 857-5765

409 W Pont Des Mouton Rd C
Couret Farms Urgent Care
Lafayette, LA 70507-3271
Phone (337) 886-6455

4402 U S Hwy 167
Maurice, LA 70555-3708
Phone (337) 516-3117

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Lafayette Health Ventures Inc. CurrentSince Sep 15, 2018 Accepting new patients
Convenient Care LLC CurrentSince Sep 7, 2007 Accepting new patients
Lafayette Health Ventures Inc CurrentSince Sep 15, 2018 Accepting new patients
Convenient Care LLC CurrentSince Sep 7, 2007 Accepting new patients
Lafayette Health Ventures, Inc Past Accepting new patients
Our Lady of the Lake Hospital Inc Past Accepting new patients
Lake Charles Primary Care and Wellness Past Accepting new patients

Locations

12525 Perkins Rd
#B
Baton Rouge, LA 70810
Phone (225) 819-8857

31985 LA Highway 16
Denham Springs, LA 70726
Phone (225) 485-3521

1216 Camellia Blvd
Lafayette, LA 70508
Phone (337) 769-0069

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

115 Audubon Blvd
Lafayette, LA 70503
Phone (337) 289-8933

409 W Pont des Mouton Rd
Ste B
Lafayette, LA 70507
Phone (337) 806-1525

409 W Pont des Mouton Rd
Ste C
Lafayette, LA 70507
Phone (337) 886-6455

4402 U S Highway 167
Ste A
Maurice, LA 70555
Phone (337) 516-3110

2810 Bonin Rd
Youngsville, LA 70592
Phone (337) 857-5765

18989 Old Scenic Hwy
Zachary, LA 70791
Phone (225) 654-6140

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

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": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332201600000",
    "number": "1992989941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD",
            "address_2": "SUITE 1004-154",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084300",
            "telephone_number": "225-214-9352",
            "fax_number": "225-214-9349"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12525 PERKINS RD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708101907",
            "telephone_number": "225-819-8857",
            "fax_number": "225-767-6822"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LATIOLAIS",
        "first_name": "MATTHEW",
        "middle_name": "STEPHEN",
        "credential": "P.A.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-12-27",
        "last_updated": "2012-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "PA.200141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1027839",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.