Individual provider Active NPI

Deidre L. Stelly, MD

  • Family Medicine Physician
  • Breaux Bridge, LA
National Provider Identifier
1144218868
Registry record updated Apr 20, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
022380 Issued in LA
Practice address
548 Lakes Blvd
Breaux Bridge, LA 70517-3248
Phone
(337) 332-0661
Fax
(337) 332-0651
NPI assigned
Oct 6, 2005
Last updated
Apr 20, 2017By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2017

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 022380 LA Primary

Addresses

Primary practice location

548 Lakes Blvd
Breaux Bridge, LA 70517-3248

Mailing address

PO Box 84460
Baton Rouge, LA 70884-4460
Phone (225) 526-0018

Other identifiers 1

IdentifierTypeStateIssuer
1677655MedicaidLA

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
I20041214000397 LA Practitioner - Family Practice 9335106178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Louisiana State University School of Medicine in New Orleans, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Lsuhn Billing LLCGroup PAC ID 0446337802, 203 clinicians

Practice addresses (Care Compare)

2390 W Congress St
Lafayette, LA 70506-4205
Phone (337) 261-6000

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
96.05 of 100Reported as group
Quality
82.12
Promoting interoperability
100
Improvement activities
40
Cost
71.37

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jeanne D. Theriot MD Apmllc Family Medicine Past Accepting new patients
Lsu Healthcare Network - Lafayette Past Accepting new patients

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1128556800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1492646400000",
    "number": "1144218868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 84460",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708844460",
            "telephone_number": "225-526-0018",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "548 LAKES BLVD",
            "city": "BREAUX BRIDGE",
            "state": "LA",
            "postal_code": "705173248",
            "telephone_number": "337-332-0661",
            "fax_number": "337-332-0651"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STELLY",
        "first_name": "DEIDRE",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-06",
        "last_updated": "2017-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "LA",
            "license": "022380",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1677655",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Breaux Bridge, LA

Sources for this page

Verify at the official NPI Registry.