Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Michael Shane Bodin, MD

Individual provider Family Medicine Physician · NPI 1376743427

Dr. Michael Shane Bodin, MD is a Family Practice in Gonzales, Louisiana. Graduated from Louisiana State University School of Medicine in New Orleans in 2005, 21 years ago. Practices with Our Lady of the Lake Physician Group LLC, a 635-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Louisiana.

Years since qualifying
21
Trained at
Louisiana State University School of Medicine in New Orleans
Licensed in
LA
In the registry since
2007
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

2647 S Saint Elizabeth Blvd Ste 219
Gonzales, LA 70737-5020
Phone: (225) 765-5500
Fax: (225) 743-2620
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 200969 (LA)

Record details

NPI number1376743427
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedJuly 18, 2007
Last updated in NPPESJanuary 14, 2021
Certification dateJanuary 14, 2021
Mailing address2647 S Saint Elizabeth Blvd, Gonzales, LA 70737-5021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolLOUISIANA STATE UNIVERSITY SCHOOL OF MEDICINE IN NEW ORLEANS
Graduated 2005 (21 years in practice)
Group practice Our Lady Of The Lake Physician Group Llc — 635 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Gonzales