Individual provider Active NPI

Debashree Mallik, CRNA

  • Certified Registered Nurse Anesthetist
  • Metairie, LA
National Provider Identifier
1285856492
Registry record updated Sep 1, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
103829 Issued in LA
Practice address
3510 N Causeway Blvd
Suite 404
Metairie, LA 70002-3531
Phone
(504) 779-5515
Fax
(504) 779-5568
NPI assigned
May 3, 2007
Last updated
Sep 1, 2009By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 103829 LA Primary

Addresses

Primary practice location

3510 N Causeway Blvd
Suite 404
Metairie, LA 70002-3531

Mailing address

255 W Michigan Ave
Jackson, MI 49201-2218
Phone (800) 242-1131

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071106000636 LA Practitioner - Certified Registered Nurse Anesthetist (Crna) 1759478829 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
103829LAMDCertified Registered Nurse Anesthetist

Practice roles

OrganizationSpecialtyStatusNew patients
Anesthesiology Affiliates, LLC Nurse Anesthetist, Certified Registered CurrentSince May 7, 2024 Accepting new patients
Parish Anesthesia Associates, LTD Apmc Nurse Anesthetist, Certified Registered Past Accepting new patients

Locations

9103 Jefferson Hwy
Baton Rouge, LA 70809
Phone (225) 927-1190

Organizations & group practices 2

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": "1178150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251763200000",
    "number": "1285856492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492012218",
            "telephone_number": "800-242-1131",
            "fax_number": "517-787-4146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 N CAUSEWAY BLVD",
            "address_2": "SUITE 404",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023531",
            "telephone_number": "504-779-5515",
            "fax_number": "504-779-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALLIK",
        "first_name": "DEBASHREE",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-03",
        "last_updated": "2009-09-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "LA",
            "license": "103829",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.