Champ Phuphanich, FNP - Medicare Nurse Practitioner in Thibodaux, LA

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Champ Phuphanich, FNP is a medicare enrolled "Nurse Practitioner - Family" in Thibodaux, Louisiana. He graduated from nursing school in 2021 and has 3 years of diverse experience with area of expertise as Nurse Practitioner. He is a member of the group practice Independence Emergency Group Llc, Bayoumd Urgent Healthcare Llc, St Mary Emergency Group Llc and his current practice location is 305 E 1st St, Thibodaux, Louisiana. You can reach out to his office (for appointments etc.) via phone at (985) 228-6028.

Champ Phuphanich is licensed to practice in Louisiana (license number 224407) and he also participates in the medicare program. He accepts medicare assignments (which means he accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and his NPI Number is 1023765427.

Contact Information

Champ Phuphanich, FNP
305 E 1st St,
Thibodaux, LA 70301-3341
(985) 228-6028
Not Available

Map and Direction




Provider's Profile

Full NameChamp Phuphanich
GenderMale
SpecialityNurse Practitioner
Experience3 Years
Location305 E 1st St, Thibodaux, Louisiana
Accepts Medicare AssignmentsYes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Champ Phuphanich graduated from nursing school in 2021
  NPI Data:
  • NPI Number: 1023765427
  • Provider Enumeration Date: 03/04/2022
  • Last Update Date: 04/16/2024
  Medicare PECOS Information:
  • PECOS PAC ID: 6002295276
  • Enrollment ID: I20220617001183

Medical Identifiers

Medical identifiers for Champ Phuphanich such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1023765427NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
363LF0000XNurse Practitioner - Family 224407 (Louisiana)Primary

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Independence Emergency Group Llc428475932518
Bayoumd Urgent Healthcare Llc65072174523
St Mary Emergency Group Llc781092699516

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. Champ Phuphanich allows following entities to bill medicare on his behalf.
Entity NameSouth Louisiana Medical Associates
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1942301379
PECOS PAC ID: 8527968650
Enrollment ID: O20040113000589
Entity NameSt Mary Emergency Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1235108499
PECOS PAC ID: 7810926995
Enrollment ID: O20050809000607
Entity NameIndependence Emergency Group Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1528384773
PECOS PAC ID: 4284759325
Enrollment ID: O20100914000327
Entity NameBayoumd Urgent Healthcare Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1306628508
PECOS PAC ID: 6507217452
Enrollment ID: O20240104004400

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. Champ Phuphanich 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
Champ Phuphanich, FNP
305 E 1st St,
Thibodaux, LA 70301-3341

Ph: () -		Champ Phuphanich, FNP
305 E 1st St,
Thibodaux, LA 70301-3341

Ph: (985) 228-6028

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    
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

Medicare Program: Medicare is a federal government program which provides health insurance to people who are 65 or older. This program also covers certain younger people with disabilities (who receive Social Security Disability Insurance - SSDI), and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant, sometimes called ESRD.

Medicare Assignment: Assignment means that your doctor, provider, or supplier agrees (or is required by law) to accept the Medicare-approved amount as full payment for covered services. Most doctors, providers, and suppliers accept assignment, but you should always check to make sure. Participating providers have signed an agreement to accept assignment for all Medicare-covered services.

NPI Number: The National Provider Identifier (NPI) is a unique identification number for covered health care providers. The NPI must be used in lieu of legacy provider identifiers in the HIPAA standards transactions. Covered health care providers and all health plans and health care clearinghouses must use the NPIs in the administrative and financial transactions adopted under HIPAA (Health Insurance Portability and Accountability Act).

Our Data: Information on www.medicarelist.com is built using data sources published by Centers for Medicare & Medicaid Services (CMS) under Freedom of Information Act (FOIA). The information disclosed on the NPI Registry are FOIA-disclosable and are required to be disclosed under the FOIA and the eFOIA amendments to the FOIA. There is no way to 'opt out' or 'suppress' the NPPES record data for health care providers with active NPIs.