Deirdre Irene Detraz, ANPC

Primary specialty

Adult Health Nurse PractitionerTaxonomy code 363LA2200X

License

APO 4805 Issued in LA

Practice address

207 N Luke St
Lafayette, LA 70506

Phone

(337) 739-7278

Fax

(337) 419-0533

NPI assigned

Jul 14, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ochsner Lafayette General Medical Center Hospital, Lafayette, LA, CCN 190002

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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

• Apex Prevention, LLC

  • Adult Health Nurse Practitioner
  • Lafayette, LA
  • NPI 1588917603
  Medicare reassignment NPD Authorized official
• Cardiovascular Institute of the South, LLC

  • Cardiovascular Disease Physician
  • Houma, LA
  • NPI 1982689113
  NPD (past)
• David G Baker MD Apmc

  dba Lafayette Heart Clinic

  • Cardiovascular Disease Physician
  • Lafayette, LA
  • NPI 1215013008
  NPD (past)
• Neurological Associates of Louisiana, L.L.C.

  • Neurological Surgery Physician
  • Lafayette, LA
  • NPI 1083721856
  NPD (past)
• Wellness Express, LLC

  • Clinic/Center
  • Lafayette, LA
  • NPI 1205163490
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Lafayette General Medical Center Inc

  • General Acute Care Hospital
  • Lafayette, LA
  • NPI 1275536799
  Care Compare affiliation

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

{
    "created_epoch": "1152835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1396761060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 81095",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "705981095",
            "telephone_number": "337-739-7278",
            "fax_number": "337-989-7036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "207 N LUKE ST",
            "city": "LAFAYETTE",
            "state": "LA",
            "postal_code": "70506",
            "telephone_number": "337-739-7278",
            "fax_number": "337-419-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETRAZ",
        "first_name": "DEIRDRE",
        "middle_name": "IRENE",
        "credential": "ANPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-14",
        "last_updated": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "LA",
            "license": "APO 4805",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1031224",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mallory Claire Desormeaux, MA, BCBA
• Shayla R. Despanie
• Braden Conrad Despot, MD
• Destined for Options - Lafayette
• Destined for Options Lafayette
• Janci Bienvenu Detwiler, CPNP-PC/AC
• Ellen Devalcourt, PT
• Todd A Devalcourt, P.A.
• Muralidhara R Devarapalli, M.D.
• Elizabeth Devargas, PLPC

• Adult Health Nurse Practitioner in Lafayette, LA
• Providers in Lafayette, LA by specialty
• Adult Health Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.