Dr Ime Emerson Udom, PT, DPT, PHD is a medicare enrolled "Physical Therapist" provider in Chauvin, Louisiana. His current practice location is
5108 Hwy 56, Chauvin, Louisiana. You can reach out to his office (for appointments etc.) via phone at
(985) 594-8332.
Dr Ime Emerson Udom is licensed to practice in Louisiana (license number 02072F) 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 1881746766.
Healthcare Provider's Profile
Full Name | Dr Ime Emerson Udom |
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Gender | Male |
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Speciality | Physical Therapist |
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Location | 5108 Hwy 56, Chauvin, Louisiana |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1881746766
- Provider Enumeration Date: 01/18/2007
- Last Update Date: 08/16/2007
Medicare PECOS Information:
- PECOS PAC ID: 7911003355
- Enrollment ID: I20100914000513
Medical Identifiers
Medical identifiers for Dr Ime Emerson Udom such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1881746766 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
225100000X | Physical Therapist | 02072F (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. Dr Ime Emerson Udom allows following entities to bill medicare on his behalf.
Provider Name | Lifespan Physical Therapy, Llc |
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Provider Type | Part B Supplier - Clinic/group Practice |
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Provider Identifiers | NPI Number: 1700973054 PECOS PAC ID: 8921104365 Enrollment ID: O20070502000170 |
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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. Dr Ime Emerson Udom 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 |
Dr Ime Emerson Udom, PT, DPT, PHD Po Box 58, Chauvin, LA 70344-0058 Ph: (985) 594-8332 | Dr Ime Emerson Udom, PT, DPT, PHD 5108 Hwy 56, Chauvin, LA 70344-8316 Ph: (985) 594-8332 |
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