Individual provider Active NPI

Naomi Hess Pellichino, PA-C

  • Physician Assistant
  • Covington, LA
National Provider Identifier
1386118032
Registry record updated Mar 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
311625 Issued in LA
Practice address
1431 Ochsner Blvd Ste B
Covington, LA 70433-8246
Phone
(985) 892-2950
Fax
(985) 892-2980
NPI assigned
Jan 16, 2019
Last updated
Mar 19, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 19, 2021

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 311625 LA Primary

Addresses

Primary practice location

1431 Ochsner Blvd Ste B
Covington, LA 70433-8246

Mailing address

1431 Ochsner Blvd Ste B
Covington, LA 70433-8246
Phone (985) 892-2950

Other practice location 1

3100 Galleria Blvd #301
Metairie, LA 70001
Phone (504) 291-3158

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
I20190830002225 LA Practitioner - Physician Assistant 7810226719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiovascular and Thoracic Surgeons of the South, LLCGroup PAC ID 8527215003, 3 clinicians

Practice addresses (Care Compare)

4080 Lonesome Rd
Suite a
Mandeville, LA 70448-7093
Phone (985) 892-2950

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
311625LAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Vein Clinics of Hawaii LLC CurrentSince Jun 28, 2020 Accepting new patients

Locations

1431 Ochsner Blvd
Ste B
Covington, LA 70433
Phone (985) 590-3488

4080 Lonesome Rd
Ste A
Mandeville, LA 70448
Phone (985) 892-2950

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": "1547596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616112000000",
    "number": "1386118032",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 OCHSNER BLVD STE B",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338246",
            "telephone_number": "985-892-2950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1431 OCHSNER BLVD STE B",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704338246",
            "telephone_number": "985-892-2950",
            "fax_number": "985-892-2980"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Galleria Blvd #301",
            "address_purpose": "LOCATION",
            "city": "Metairie",
            "state": "LA",
            "postal_code": "70001",
            "country_code": "US",
            "telephone_number": "504-291-3158",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PELLICHINO",
        "first_name": "NAOMI",
        "middle_name": "HESS",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-01-16",
        "last_updated": "2021-03-19",
        "certification_date": "2021-03-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "LA",
            "license": "311625",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.