Individual provider Active NPI

Michael Eddie Cormier, M.D.

  • Dermatology Physician
  • Lake Charles, LA
National Provider Identifier
1003895756
Registry record updated Sep 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
014726 Issued in LA
Practice address
2000 Tybee St
Lake Charles, LA 70605-4171
Phone
(337) 433-7272
Fax
(337) 433-0730
NPI assigned
Jan 11, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 014726 LA Primary

Addresses

Primary practice location

2000 Tybee St
Lake Charles, LA 70605-4171

Mailing address

2000 Tybee St
Lake Charles, LA 70605-4171
Phone (337) 433-7272

Other identifiers 1

IdentifierTypeStateIssuer
1360660MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060130000016 LA Practitioner - Dermatology 5496769465 Reassigns benefits to 1 organization
Practice locations: Lake Charles, LA

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in New Orleans, 1978
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Dermatology Associates of Swla LLCGroup PAC ID 6608003736, 7 clinicians

Practice addresses (Care Compare)

2000 Tybee LN
Lake Charles, LA 70605-4171
Phone (337) 433-7272

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
82.26 of 100Reported as group
Quality
84.77
Improvement activities
40
Cost
61.18

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions4264
Skin biopsy676

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
014726LAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dermatology Associates of Swla LLC Dermatology CurrentSince Jan 1, 2014 Accepting new patients

Locations

2000 Tybee Ln
Lake Charles, LA 70605
Phone (337) 310-2380

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1136937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694476800000",
    "number": "1003895756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 TYBEE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054171",
            "telephone_number": "337-433-7272",
            "fax_number": "337-433-0730"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2000 TYBEE ST",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706054171",
            "telephone_number": "337-433-7272",
            "fax_number": "337-433-0730"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORMIER",
        "first_name": "MICHAEL",
        "middle_name": "EDDIE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-01-11",
        "last_updated": "2023-09-12",
        "certification_date": "2023-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "014726",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1360660",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.