Individual provider Active NPI

Whitney Meshell Domangue, PA-C

  • Physician Assistant
  • Slidell, LA
National Provider Identifier
1124801345
Registry record updated Oct 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
337629 Issued in LA
Practice address
1001 Gause Blvd
Slidell, LA 70458-2987
Phone
(985) 280-2200
NPI assigned
Aug 14, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 337629 LA Primary

Addresses

Primary practice location

1001 Gause Blvd
Slidell, LA 70458-2987

Mailing address

13232 Village Trace Dr
Folsom, LA 70437-6145
Phone (870) 415-7896

Other practice location 1

2500 Belle Chasse Hwy
Gretna, LA 70056
Phone (504) 392-3131

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231208002341 LA Practitioner - Physician Assistant 3476902966 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Belle Chasse Physician Services LLCGroup PAC ID 9335379379, 258 clinicians

Practice addresses (Care Compare)

100 Medical Ctr Dr
Slidell, LA 70461-5520
Phone (985) 646-5100

1001 Gause Blvd
Slidell, LA 70458-2939
Phone (985) 643-2200

Hospital & facility affiliations

  • Slidell Memorial Hospital Hospital, Slidell, LA, CCN 190040
  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036

Merit-based Incentive Payment System (MIPS)

Final score
79.21 of 100Reported as group
Quality
64.85
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Interoperability endpoints

  • Direct secure messaging: wmeshell520566@direct.ochsner.org

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.

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": "1691971200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729728000000",
    "number": "1124801345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13232 VILLAGE TRACE DR",
            "city": "FOLSOM",
            "state": "LA",
            "postal_code": "704376145",
            "telephone_number": "870-415-7896"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 GAUSE BLVD",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704582987",
            "telephone_number": "985-280-2200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 Belle Chasse Hwy",
            "address_purpose": "LOCATION",
            "city": "Gretna",
            "state": "LA",
            "postal_code": "70056",
            "country_code": "US",
            "telephone_number": "504-392-3131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DOMANGUE",
        "first_name": "WHITNEY",
        "middle_name": "MESHELL",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-14",
        "last_updated": "2024-10-24",
        "certification_date": "2024-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "337629",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.