NPIMap

Individual provider Active NPI

Mae M. Dumlao, M.D.

  • Internal Medicine Physician
  • Covington, LA
National Provider Identifier
1144414020
Registry record updated Mar 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
205110 Issued in LA
Practice address
1202 S. Tyler Street
Covington, LA 70433-2330
Phone
(985) 898-4194
Fax
(985) 898-4164
NPI assigned
Sep 4, 2007
Last updated
Mar 27, 2012By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 37211 AZ
Internal Medicine Physician 207R00000X 205110 LA Primary

Addresses

Primary practice location

1202 S. Tyler Street
Covington, LA 70433-2330

Mailing address

1202 S. Tyler Street
Covington, LA 70433-2330
Phone (985) 898-4194

Other identifiers 1

IdentifierTypeStateIssuer
320528MedicaidAZ

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
I20120207000599 LA Practitioner - Internal Medicine 6800980509 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1202 S Tyler St
Covington, LA 70433-2330
Phone (985) 898-3743

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
205110LAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Tammany Parish Hospital Service District No 1 Internal Medicine CurrentSince Jan 1, 2012 Accepting new patients
St. Tammany Parish Hospital Service District No 1 CurrentSince Jan 1, 2012 Accepting new patients
Ipn of Arizona, PLC Internal Medicine Past Accepting new patients
Apogee Medical Group Virginia, PC Internal Medicine Past Accepting new patients
Apogee Medical Group, Louisiana, Inc. Past Accepting new patients

Locations

1202 S Tyler St
Covington, LA 70433
Phone (985) 898-3743

Organizations & group practices 5

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 3

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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332806400000",
    "number": "1144414020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1202 S. TYLER STREET",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332330",
            "telephone_number": "985-898-4194",
            "fax_number": "985-898-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1202 S. TYLER STREET",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332330",
            "telephone_number": "985-898-4194",
            "fax_number": "985-898-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUMLAO",
        "first_name": "MAE",
        "middle_name": "M.",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2012-03-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "37211",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "LA",
            "license": "205110",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "320528",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.