Organization Active NPI

Haydel Dermatology

  • Dermatology Physician
  • Houma, LA
National Provider Identifier
1104994300
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
024925 Issued in LA
Legal business name
HAYDEL DERMATOLOGY
Practice address
578 Valhi Blvd
Houma, LA 70360-5974
Phone
(985) 223-3871
Fax
(985) 223-8779
NPI assigned
Dec 4, 2006
Last updated
Oct 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Sarah Alexander Haydel, M.D.NPI 1811965932
Title
President
Phone
(985) 223-3871

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 024925 LA Primary

Addresses

Primary practice location

578 Valhi Blvd
Houma, LA 70360-5974

Mailing address

578 Valhi Blvd
Houma, LA 70360-5974
Phone (985) 223-3871

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100111000452 LA Part B Supplier - Clinic/Group Practice 9133260359 Receives reassigned benefits from 3 practitioners
Practice locations: Houma, LA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D2014893Haydel Dermatology578 Valhi Blvd, Houma, LA 70360Provider-performed microscopyOct 17, 2026

National Provider Directory

National Provider Directory

Locations

578 Valhi Blvd
Houma, LA 70360
Phone (985) 223-3871

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1165190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1104994300",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "578 VALHI BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703605974",
            "telephone_number": "985-223-3871",
            "fax_number": "985-223-8779"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "578 VALHI BLVD",
            "city": "HOUMA",
            "state": "LA",
            "postal_code": "703605974",
            "telephone_number": "985-223-3871",
            "fax_number": "985-223-8779"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HAYDEL DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-04",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "HAYDEL",
        "authorized_official_first_name": "SARAH",
        "authorized_official_middle_name": "ALEXANDER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "985-223-3871",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "024925",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houma, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.