Dustin David Denicola, N.P.

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

RN117110-AP06574 Issued in LA

Practice address

4950 Essen LN
Suite 300
Baton Rouge, LA 70809-3738

Phone

(225) 490-8882

Fax

(225) 765-9085

NPI assigned

Apr 10, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

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: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Nurse Practitioner

Education

Other, 2010

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064
• Womans Hospital Hospital, Baton Rouge, LA, CCN 190128

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ddenicola15925@direct.casso.us.com

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.

• Our Lady of the Lake Physician Group LLC

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1033494943

  Nurse Practitioner

  Medicare reassignment Care Compare group NPD
• Our Lady of the Lake Physician Group LLC

  • Comprehensive Outpatient Rehabilitation Facility (CORF)
  • Baton Rouge, LA
  • NPI 1235912502
  NPD
• Our Lady of the Lake Physician Group, LLC

  • Urgent Care Clinic/Center
  • Baton Rouge, LA
  • NPI 1588062079
  NPD
• Northshore Oncology Associates, LLC

  • Hematology & Oncology Physician
  • Slidell, LA
  • NPI 1609165711
  NPD (past)

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

• Our Lady of the Lake Hospital Inc.

  • General Acute Care Hospital
  • Baton Rouge, LA
  • NPI 1366436123
  Care Compare affiliation
• Woman'S Hospital Foundation

  • General Acute Care Hospital
  • Baton Rouge, LA
  • NPI 1912943184
  Care Compare affiliation

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

{
    "created_epoch": "1334016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490227200000",
    "number": "1073879508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84460",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708844460",
            "telephone_number": "225-526-6001",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 ESSEN LN",
            "address_2": "SUITE 300",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093738",
            "telephone_number": "225-490-8882",
            "fax_number": "225-765-9085"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DENICOLA",
        "first_name": "DUSTIN",
        "middle_name": "DAVID",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-10",
        "last_updated": "2017-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "RN117110-AP06574",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2314815",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00985562",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tracy Maureen Dempsey
• Amber Ashlee Denham-Ruiz, MD
• Jason Denham
• Rebecca Brockhaus Denham, MA
• Dawn Miller Denicola, NP-C
• Caroline Ruiz Denison, PT, DPT
• Britney Danielle Denley
• Seanna Denmark
• Charles J. Dennis Jr., LPC, M.P.A.
• Jena Dennis, CSW

• Adult Health Nurse Practitioner in Baton Rouge, LA
• Providers in Baton Rouge, LA by specialty
• Adult Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.