Theresa Bourg Vicknair, CRNA - Medicare Certified Registered Nurse Anesthetist (crna) in Lutcher, LA

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Theresa Bourg Vicknair, CRNA is a medicare enrolled "Nurse Anesthetist, Certified Registered" in Lutcher, Louisiana. She graduated from nursing school in 1987 and has 37 years of diverse experience with area of expertise as Certified Registered Nurse Anesthetist (crna). She is a member of the group practice Zephyr Anesthesia Llc and her current practice location is St James Parish Hosipital, Louisiane Ave, Lutcher, Louisiana. You can reach out to her office (for appointments etc.) via phone at (225) 869-5512.

Theresa Bourg Vicknair is licensed to practice in Louisiana (license number AP01519) and she also participates in the medicare program. She accepts medicare assignments (which means she accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance) and her NPI Number is 1134100746.

Contact Information

Theresa Bourg Vicknair, CRNA
St James Parish Hosipital, Louisiane Ave,
Lutcher, LA 70071
(225) 869-5512
Not Available

Map and Direction




Provider's Profile

Full NameTheresa Bourg Vicknair
GenderFemale
SpecialityCertified Registered Nurse Anesthetist (crna)
Experience37 Years
LocationSt James Parish Hosipital, Lutcher, Louisiana
Accepts Medicare AssignmentsYes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance.
  Medical Education and Training:
  • Theresa Bourg Vicknair graduated from nursing school in 1987
  NPI Data:
  • NPI Number: 1134100746
  • Provider Enumeration Date: 11/10/2005
  • Last Update Date: 07/08/2007
  Medicare PECOS Information:
  • PECOS PAC ID: 2163614751
  • Enrollment ID: I20101014000905

Medical Identifiers

Medical identifiers for Theresa Bourg Vicknair such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1134100746NPI-NPPES

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
163W00000XRegistered Nurse RN059871 (Louisiana)Primary
367500000XNurse Anesthetist, Certified Registered AP01519 (Louisiana)Primary

Medical Facilities Affiliation

Facility NameLocationFacility Type
St James Parish HospitalLutcher, LAHospital

Group Practice Association

Group Practice NameGroup PECOS PAC IDNo. of Members
Zephyr Anesthesia Llc165855912575

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. Theresa Bourg Vicknair allows following entities to bill medicare on her behalf.
Entity NameChildrens Hospital Anesthesia Corporation
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1649362740
PECOS PAC ID: 0446152862
Enrollment ID: O20040124000258
Entity NamePhysicians Medical Center, Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1477509859
PECOS PAC ID: 2062308364
Enrollment ID: O20040224000911
Entity NameZephyr Anesthesia Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1891087458
PECOS PAC ID: 1658559125
Enrollment ID: O20110705000180
Entity NameHola Anesthesia Llc
Entity TypePart B Supplier - Clinic/group Practice
Entity IdentifiersNPI Number: 1023598067
PECOS PAC ID: 3476891789
Enrollment ID: O20190212002247

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. Theresa Bourg Vicknair 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
Theresa Bourg Vicknair, CRNA
124 Jennifer Ln,
La Place, LA 70068-5806

Ph: (985) 359-0599		Theresa Bourg Vicknair, CRNA
St James Parish Hosipital, Louisiane Ave,
Lutcher, LA 70071

Ph: (225) 869-5512

Reviews and Comments


Nurse Anesthetist, Certified Registered Nurses in Lutcher, LA


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.