NPIMap

Individual provider Active NPI

Brad C Giarrusso, MD

  • Internal Medicine Physician
  • Baker, LA
National Provider Identifier
1104844455
Registry record updated Jan 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
026403 Issued in LA
Practice address
6516 E Myrtle Ave
Baker, LA 70714-4348
Phone
(225) 765-5500
Fax
(225) 774-5432
NPI assigned
Jul 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 026403 LA
Internal Medicine Physician 207R00000X 026403 LA Primary

Addresses

Primary practice location

6516 E Myrtle Ave
Baker, LA 70714-4348

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 526-0177

Other identifiers 1

IdentifierTypeStateIssuer
1065421MedicaidLA

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address bgiarrusso14225@direct.casso.us.com Direct
FHIR URL https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/ Other

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050613000014 LA Practitioner - Internal MedicinePractitioner - Pediatric Medicine 3971547852 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Pediatric Medicine
Education
Louisiana State University School of Medicine in New Orleans, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Our Lady of the Lake Physician Group LLCGroup PAC ID 4587849781, 637 clinicians

Practice addresses (Care Compare)

6516 E Myrtle Ave
Baker, LA 70714-4348
Phone (225) 774-7320

Hospital & facility affiliations

  • Amedisys Home Health Home health agency, Baton Rouge, LA, CCN 197437
  • Womans Hospital Hospital, Baton Rouge, LA, CCN 190128
  • Lane Regional Medical Center Hospital, Zachary, LA, CCN 190020
  • Our Lady of the Lake Regional Medical Center Hospital, Baton Rouge, LA, CCN 190064

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
026403LAMDPediatrics Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC Internal Medicine Current Accepting new patients
Our Lady of the Lake Physician Group, LLC CurrentSince May 23, 2016 Accepting new patients
Our Lady of the Lake Physician Group LLC CurrentSince May 23, 2016 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients

Locations

6516 E Myrtle Ave
Baker, LA 70714
Phone (225) 774-7320

11424 Sullivan Rd
#A-C
Baton Rouge, LA 70818
Phone (225) 261-7021

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

Networks

  • LA PPO C-SNP

Organizations & group practices 4

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 9

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": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1610064000000",
    "number": "1104844455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-526-0177",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6516 E MYRTLE AVE",
            "city": "BAKER",
            "state": "LA",
            "postal_code": "707144348",
            "telephone_number": "225-765-5500",
            "fax_number": "225-774-5432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIARRUSSO",
        "first_name": "BRAD",
        "middle_name": "C",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-17",
        "last_updated": "2021-01-08",
        "certification_date": "2021-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "LA",
            "license": "026403",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "026403",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1065421",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bgiarrusso14225@direct.casso.us.com",
            "affiliation": "N",
            "endpointDescription": "FMOLHS-Epic",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bgiarrusso14225@direct.casso.us.com",
            "address_1": "6516 E Myrtle Ave",
            "city": "Baker",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707144348",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://epicproxy.et0830.epichosted.com/FHIRProxy/api/FHIR/DSTU2/",
            "affiliation": "N",
            "endpointDescription": "FMOLHS FHIR URL",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "6516 E Myrtle Ave",
            "city": "Baker",
            "state": "LA",
            "country_code": "US",
            "postal_code": "707144348",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Baker, LA

Sources for this page

Verify at the official NPI Registry.