Individual provider Active NPI

Venetia Marie Nicole Patout, MD

  • Dermatology Physician
  • New Iberia, LA
National Provider Identifier
1104849579
Registry record updated Feb 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
023184 Issued in LA
Practice address
602 North Lewis Street
Suite 600
New Iberia, LA 70563
Phone
(337) 560-1200
Fax
(337) 560-5554
NPI assigned
Jul 25, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2022

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 023184 LA Primary

Addresses

Primary practice location

602 North Lewis Street
Suite 600
New Iberia, LA 70563

Mailing address

511 E Main St
New Iberia, LA 70560-3819
Phone (337) 369-7722

Other identifiers 1

IdentifierTypeStateIssuer
1492485MedicaidLA

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
I20101005000150 LA Practitioner - Dermatology 0143398859 Practice locations: New Iberia, LA

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in New Orleans, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

602 N Lewis St
Suite 600
New Iberia, LA 70563-2093
Phone (337) 560-1200

Hospital & facility affiliations

  • Iberia Medical Center Hospital, New Iberia, LA, CCN 190054

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as individual

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions657
Removal or shaving of skin growth20
Skin biopsy171

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
023184LAMDDermatology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Mark B. Charbonnet, MD Apmc PastSince Jul 13, 2010 Accepting new patients
Iberia Dermatology Dermatology PastSince Jul 1, 1997 Accepting new patients

Organizations & group practices 2

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 2

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": "1153785600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645228800000",
    "number": "1104849579",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 E MAIN ST",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "705603819",
            "telephone_number": "337-369-7722",
            "fax_number": "337-560-5554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 NORTH LEWIS STREET",
            "address_2": "SUITE 600",
            "city": "NEW IBERIA",
            "state": "LA",
            "postal_code": "70563",
            "telephone_number": "337-560-1200",
            "fax_number": "337-560-5554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PATOUT",
        "first_name": "VENETIA",
        "middle_name": "MARIE NICOLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-25",
        "last_updated": "2022-02-19",
        "certification_date": "2022-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "023184",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1492485",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Iberia, LA

Sources for this page

Verify at the official NPI Registry.