Individual provider Active NPI

Celso Fernando Palmieri

  • Oral & Maxillofacial Surgery (D.M.D.)
  • Shreveport, LA
National Provider Identifier
1104095520
Registry record updated Nov 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral & Maxillofacial Surgery (D.M.D.)Taxonomy code 204E00000X
License
7147 Issued in LA
Practice address
1541 Kings Hwy
Shreveport, LA 71103-4228
Phone
(318) 626-0000
NPI assigned
Feb 29, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 12, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Oral & Maxillofacial Surgery (D.M.D.) 204E00000X 7147 LA Primary
Dentist 122300000X 7147 LA

Addresses

Primary practice location

1541 Kings Hwy
Shreveport, LA 71103-4228

Mailing address

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 626-0177

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: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080326000430 LA Practitioner - Oral Surgery 8820174246 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rapides Healthcare System LLCGroup PAC ID 0446163158, 10 clinicians

Practice addresses (Care Compare)

105 N 3Rd St
Alexandria, LA 71301-8582
Phone (318) 769-5090

1541 Kings Hwy
Shreveport, LA 71103-4228
Phone (318) 675-5000

Hospital & facility affiliations

  • Rapides Regional Medical Center Hospital, Alexandria, LA, CCN 190026
  • Ochsner Lsu Health Shreveport Hospital, Shreveport, LA, CCN 190098
  • Ochsner Lsu Health Shreveport-St Mary Medical Cent Hospital, Shreveport, LA, CCN 190317

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7147LAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Rapides Healthcare System LLC CurrentSince Jun 1, 2015 Accepting new patients
Rapides Healthcare System, LLC Current Accepting new patients
Rapides Healthcare System, LLC CurrentSince Jun 1, 2015 Accepting new patients
Lsu Health Sciences Center Shreveport Faculty Group Practice Oral & Maxillofacial Surgery CurrentSince Dec 1, 2016 Accepting new patients
Brfhh Shreveport LLC Past Accepting new patients
Ochsner Lsu Health Shreveport - St. Mary Medical Center, LLC Past Accepting new patients

Locations

105 N 3rd St
Alexandria, LA 71301
Phone (318) 769-5093

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

1501 Kings Hwy
Rm 1201
Shreveport, LA 71103
Phone (318) 675-4881

1541 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0287

1606 Kings Hwy
Shreveport, LA 71103
Phone (318) 675-6402

2600 Kings Hwy
Ste 300
Shreveport, LA 71103
Phone (318) 212-8344

1501 Kings Hwy
Shreveport, LA 71103
Phone (318) 626-0434

Interoperability endpoints

  • Direct secure messaging: cpalmieri772104@direct.ochsner.org

Organizations & group practices 6

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 5

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": "1204243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731369600000",
    "number": "1104095520",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 KINGS HWY",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711034228",
            "telephone_number": "318-626-0000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALMIERI",
        "first_name": "CELSO",
        "middle_name": "FERNANDO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-02-29",
        "last_updated": "2024-11-12",
        "certification_date": "2024-11-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204E00000X",
            "taxonomy_group": "",
            "desc": "Oral & Maxillofacial Surgery",
            "state": "LA",
            "license": "7147",
            "primary": true
        },
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "LA",
            "license": "7147",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.