Individual provider Active NPI

Brandy A Glorioso, PA

  • Medical Physician Assistant
  • New Orleans, LA
National Provider Identifier
1417216177
Registry record updated Mar 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.200520 Issued in LA
Practice address
2700 Napoleon Ave
New Orleans, LA 70115-6914
Phone
(504) 842-5300
Fax
(504) 842-5389
NPI assigned
May 15, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA.200520 LA Primary

Addresses

Primary practice location

2700 Napoleon Ave
New Orleans, LA 70115-6914

Mailing address

2700 Napoleon Ave
New Orleans, LA 70115-6914
Phone (504) 842-5300

Other names 1

  • Brandy A Bacon Former name

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
I20120606000061 LA Practitioner - Physician Assistant 7517121452 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

105 Medical Ctr Dr
Slidell, LA 70461-5544
Phone (985) 639-3777

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3000

1516 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-3470

71380 Hwy 21
Covington, LA 70433-7245
Phone (985) 661-3534

Hospital & facility affiliations

  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
  • Slidell Memorial Hospital Hospital, Slidell, LA, CCN 190040

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Jun 4, 2012 Accepting new patients
Ochsner Clinic LLC CurrentSince Jun 4, 2012 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

1514 Jefferson Hwy
New Orleans, LA 70121

2700 Napoleon Ave
New Orleans, LA 70115
Phone (504) 842-3650

105 Medical Center Dr
Ste 205
Slidell, LA 70461
Phone (985) 646-2411

105 Medical Center Dr
Slidell, LA 70461
Phone (985) 661-3534

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1337040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1488931200000",
    "number": "1417216177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 NAPOLEON AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701156914",
            "telephone_number": "504-842-5300",
            "fax_number": "504-842-5389"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 NAPOLEON AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701156914",
            "telephone_number": "504-842-5300",
            "fax_number": "504-842-5389"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GLORIOSO",
        "first_name": "BRANDY",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-05-15",
        "last_updated": "2017-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "PA.200520",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BRANDY",
            "last_name": "BACON",
            "middle_name": "A",
            "credential": "PA",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.