Blake Larose, FNP in Thibodaux, LA - Medicare Nurse Practitioner

Blake Larose, FNP is a medicare enrolled "Nurse Practitioner - Family" in Thibodaux, Louisiana. His current practice location is 400 N Acadia Rd, Thibodaux, Louisiana. You can reach out to his office (for appointments etc.) via phone at (985) 493-4004.

Blake Larose is licensed to practice in Louisiana (license number 201963) 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 1366129769.

Contact Information

	Blake Larose, FNP
	400 N Acadia Rd, Thibodaux, LA 70301-4856
	(985) 493-4004
	Not Available

Map and Direction

Provider's Profile

Full Name	Blake Larose
Gender	Male
Speciality	Nurse Practitioner - Family
Location	400 N Acadia Rd, Thibodaux, Louisiana
Accepts Medicare Assignments	Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs.

NPI Data:

NPI Number: 1366129769
Provider Enumeration Date: 06/28/2023
Last Update Date: 06/28/2023

Medicare PECOS Information:

PECOS PAC ID: 7315301462
Enrollment ID: I20230908000205

Medical Identifiers

Medical identifiers for Blake Larose such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1366129769	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
363LF0000X	Nurse Practitioner - Family	201963 (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. Blake Larose allows following entities to bill medicare on his behalf.

Entity Name	Thibodaux Regional Network Development Corporation
Entity Type	Part B Supplier - Clinic/group Practice
Entity Identifiers	NPI Number: 1285658310 PECOS PAC ID: 8224011754 Enrollment ID: O20040608000132

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. Blake Larose 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 Address	Practice Location Address
Blake Larose, FNP 118 Rue Celeste, Thibodaux, LA 70301-5007 Ph: (985) 803-0638	Blake Larose, FNP 400 N Acadia Rd, Thibodaux, LA 70301-4856 Ph: (985) 493-4004

Reviews and Comments

Nurse Practitioner Nurses in Thibodaux, LA

Rebecca Ann Melancon, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 602 N Acadia Rd, Thibodaux, LA 70301 Phone: 985-447-5500
Mrs. Emily Rivet Landry, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1320 Martin Luther King Dr, Thibodaux, LA 70301 Phone: 985-446-2021 Fax: 985-446-1546
Candice Eschete, Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 602 N Acadia Rd, Thibodaux, LA 70301 Phone: 985-493-4727
Champ Phuphanich, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 305 E 1st St, Thibodaux, LA 70301 Phone: 985-228-6028
Ashley Ann Dufrene, PMHNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 126 Rue Colette, Thibodaux, LA 70301 Phone: 985-625-0023
Nicholas S Fuglaar, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2031 Audubon Ave, Thibodaux, LA 70301 Phone: 985-803-8383
Ms. Sandra Lee Brommeland Gonzalez, APRN-BC Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1101 Audubon Ave, Thibodaux, LA 70301 Phone: 985-857-3615 Fax: 941-295-7336

Blake Larose, FNP - Medicare Nurse Practitioner in Thibodaux, LA