Individual provider Active NPI

Lydie S Pierre-Louis, MD

  • Family Medicine Physician
  • Greenacres, FL
National Provider Identifier
1104800614
Registry record updated Aug 31, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
ME69182 Issued in FL
Practice address
4849 Lake Worth Rd
Greenacres, FL 33463-3455
Phone
(561) 433-4446
Fax
(561) 433-3026
NPI assigned
Nov 30, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 31, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X ME69182 FL Primary

Addresses

Primary practice location

4849 Lake Worth Rd
Greenacres, FL 33463-3455

Mailing address

4849 Lake Worth Rd
Greenacres, FL 33463-3455
Phone (561) 433-4446

Other identifiers 1

IdentifierTypeStateIssuer
378810500MedicaidFL

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20120620000240 FL Practitioner - Family Practice 0244494425 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1975
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4849 Lake Worth Rd
Greenacres, FL 33463-3461

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
ME69182FLMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
PCC Medical Holdings LLC CurrentSince Jul 1, 2022 Accepting new patients

Locations

4849 Lake Worth Rd
Ste 346
Greenacres, FL 33463

4849 Lake Worth Rd
Greenacres, FL 33463
Phone (561) 202-6064

1140 S Semoran Blvd
Ste E
Orlando, FL 32807
Phone (407) 384-9165

2911 N Military Trl
Ste D
West Palm Beach, FL 33409
Phone (561) 478-8825

Interoperability endpoints

  • Direct secure messaging: lydie.pierrelouis@millake.eclinicaldirectplus.com
  • Direct secure messaging: lydie.pierre-louis.1@32578.direct.athenahealth.com

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.

NPI Registry JSON

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

{
    "created_epoch": "1133308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283212800000",
    "number": "1104800614",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4849 LAKE WORTH RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633455",
            "telephone_number": "561-433-4446",
            "fax_number": "561-433-3026"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4849 LAKE WORTH RD",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334633455",
            "telephone_number": "561-433-4446",
            "fax_number": "561-433-3026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PIERRE-LOUIS",
        "first_name": "LYDIE",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-30",
        "last_updated": "2010-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "ME69182",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "378810500",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

Verify at the official NPI Registry.