Individual provider Active NPI

Brianna McDaniel

  • Dermatology Physician
  • Covington, LA
National Provider Identifier
1285053496
Registry record updated Dec 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
307882 Issued in LA
Practice address
109 New Camellia Blvd Ste 200
Covington, LA 70433-7829
Phone
(985) 370-7546
NPI assigned
Apr 15, 2014
Last updated
Dec 30, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2021

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 307882 LA Primary

Addresses

Primary practice location

109 New Camellia Blvd Ste 200
Covington, LA 70433-7829

Mailing address

109 New Camellia Blvd Ste 200
Covington, LA 70433-7829
Phone (198) 527-7546

Other identifiers 1

IdentifierTypeStateIssuer
2479946MedicaidLA

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
I20180731003128 LA Practitioner - Dermatology 3173847571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
William Carey University College of Osteopathic Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
McDaniel Dermatology, LLCGroup PAC ID 6507279932, 3 clinicians

Practice addresses (Care Compare)

222 Hwy 21
Madisonville, LA 70447-9676
Phone (985) 277-5463

Merit-based Incentive Payment System (MIPS)

Final score
91.41 of 100Reported as individual
Quality
82.81
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision91
Removal of tissue29
Removal of skin lesions997
Removal of skin cancer394
Removal or shaving of skin growth16
Skin biopsy352

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
307882LAMDDermatology Physician

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640822400000",
    "number": "1285053496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 NEW CAMELLIA BLVD STE 200",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337829",
            "telephone_number": "198-527-7546",
            "fax_number": "985-277-5463"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 NEW CAMELLIA BLVD STE 200",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337829",
            "telephone_number": "985-370-7546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "BRIANNA",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-04-15",
        "last_updated": "2021-12-30",
        "certification_date": "2021-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "307882",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2479946",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.