Madison Rae Bolgiano, PA-C
Physician Assistant in Lafayette, LA. Individual provider (NPI-1).
NPI number1114698404
StatusActive
Last updated in NPPESSep 26, 2021
Details
- NPI
- 1114698404
- Entity type
- Individual (NPI-1)
- Name
- Madison Rae Bolgiano
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 26, 2021
- Certification date
- Sep 26, 2021
- Last updated
- Sep 26, 2021
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - PHYSICIAN ASSISTANT
- Can order and refer
- Part B Yes · DME Yes · Home health Yes · Power mobility Yes · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
Practice location
4212 W Congress St Ste 3100Lafayette, LA 70506-6771
Phone 337-703-3220
Mailing address
109 Irish Bend DrYoungsville, LA 70592-5605
Is something wrong?
This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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