Mandy L Broussard, CRNA - Medicare Nurse Anesthetist, Certified Registered in Metairie, LA

Mandy L Broussard, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Metairie, Louisiana. His current practice location is 3510 N Causeway Blvd, Suite 404, Metairie, Louisiana. You can reach out to his office (for appointments etc.) via phone at (504) 779-5515.

Mandy L Broussard is licensed to practice in Louisiana (license number RN108582) and he also participates in the medicare program. He does not accept medicare assignments directly but he may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. His NPI Number is 1124317565.

Contact Information

Mandy L Broussard, CRNA
3510 N Causeway Blvd, Suite 404,
Metairie, LA 70002-3531
(504) 779-5515
Not Available



Provider's Profile

Full NameMandy L Broussard
GenderMale
SpecialityNurse Anesthetist, Certified Registered
Location3510 N Causeway Blvd, Metairie, Louisiana
Accepts Medicare AssignmentsMedicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.
  NPI Data:
  • NPI Number: 1124317565
  • Provider Enumeration Date: 04/06/2011
  • Last Update Date: 04/06/2011
  Medicare PECOS Information:
  • PECOS PAC ID: 1557530920
  • Enrollment ID: I20110802000287

Medical Identifiers

Medical identifiers for Mandy L Broussard such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1124317565NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
367500000XNurse Anesthetist, Certified Registered RN108582 (Louisiana)Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Medicare reassignment of benefits is a mechanism by which practitioners allow third parties to bill and receive payment for medicare services performed by them. Mandy L Broussard allows following entities to bill medicare on his behalf.
Entity NameAnesthesiology Group Associates Inc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1255399598
PECOS PAC ID: 0042110298
Enrollment ID: O20040113000117

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Medicare Part D Prescriber Enrollment

Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mandy L Broussard is enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Mandy L Broussard, CRNA
255 W Michigan Ave,
Jackson, MI 49201-2218

Ph: (800) 242-1131
Mandy L Broussard, CRNA
3510 N Causeway Blvd, Suite 404,
Metairie, LA 70002-3531

Ph: (504) 779-5515

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Nurse Anesthetist, Certified Registered Nurses in Metairie, LA

Kristi F Simon, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 3510 N Causeway Blvd, Suite 404, Metairie, LA 70002
Phone: 504-779-5515    
Brian F. Brown, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 3510 N Causeway Blvd, Suite 404, Metairie, LA 70002
Phone: 504-779-5515    Fax: 504-779-5568
Dominick Diecidue, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 3510 N Causeway Blvd, Suite 404, Metairie, LA 70002
Phone: 504-779-5515    Fax: 504-779-5568
Brandon C. Brown, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 3510 N Causeway Blvd, Suite 404, Metairie, LA 70002
Phone: 504-779-5515    Fax: 504-779-5568
Joellyn Mary Grass, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 3510 N Causeway Blvd, Metairie, LA 70002
Phone: 504-779-5515    
Steve Gonzales, CRNA
Nurse Anesthetist - CR
Medicare: Not Enrolled in Medicare
Practice Location: 3510 N Causeway Blvd, Metairie, LA 70002
Phone: 504-779-5568    
Ronald E. Bankert, CRNA
Nurse Anesthetist - CR
Medicare: Accepting Medicare Assignments
Practice Location: 3510 N Causeway Blvd, Suite 404, Metairie, LA 70002
Phone: 504-779-5515    

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