Individual provider Active NPI

Derek Mimeles, MD

  • Specialist
  • Metairie, LA
National Provider Identifier
1477597490
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
10645R
Practice address
3510 N Causeway Blvd Ste 404
Metairie, LA 70002-3531
Phone
(504) 779-5568
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 10645R Primary

Addresses

Primary practice location

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

Mailing address

744 W Michigan Ave
Jackson, MI 49201-1909
Phone (517) 787-6440

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
I20050526000565 LA Practitioner - Anesthesiology 7315843802 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Anesthesiology
Education
Louisiana State University School of Medicine in New Orleans, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Childrens Hospital Anesthesia CorporationGroup PAC ID 0446152862, 281 clinicians
Jefferson Anesthesia ConsultantsGroup PAC ID 8820470057, 22 clinicians
Zephyr Anesthesia LLCGroup PAC ID 1658559125, 161 clinicians

Practice addresses (Care Compare)

1101 Medical Ctr Blvd
Marrero, LA 70072-3147
Phone 8662148600203

2701 Lake Villa Dr
Metairie, LA 70002-6701
Phone (504) 832-2115

694 Belle Terre Blvd
La Place, LA 70068-1620
Phone (985) 359-6694

Hospital & facility affiliations

  • Touro Infirmary Hospital, New Orleans, LA, CCN 190046
  • West Jefferson Medical Center Hospital, Marrero, LA, CCN 190039
  • St Charles Surgical Hospital Hospital, New Orleans, LA, CCN 190300

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Orthomed Staffing LLC Anesthesiology CurrentSince Apr 16, 2024 Accepting new patients
Jefferson Anesthesia Consultants Anesthesiology CurrentSince Aug 5, 2022 Accepting new patients
Childrens Hospital Anesthesia Corporation Anesthesiology CurrentSince Mar 1, 2017 Accepting new patients
Zephyr Anesthesia, LLC Anesthesiology CurrentSince Apr 1, 2023 Accepting new patients
Parish Anesthesia of Monroe, LLC Specialist Past Accepting new patients
Parish Anesthesia Endoscopy of Lafayette, LLC Anesthesiology PastSince Jun 9, 2009 Accepting new patients

Locations (25 of 28)

323 W Walnut Ave
Bastrop, LA 71220
Phone (318) 283-3600

8000 W Judge Perez Dr
Chalmette, LA 70043
Phone (504) 493-6078

1234 Pinnacle Pkwy
Covington, LA 70433
Phone (985) 200-1213

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

4407 Highway 190 East Service Rd
Ste 200
Covington, LA 70433
Phone (985) 234-9700

191 Innovation Ct
Ste A
Gray, LA 70359
Phone (985) 303-4050

3704 Lapalco Blvd
Harvey, LA 70058
Phone (504) 207-5320

694 Belle Terre Blvd
La Place, LA 70068
Phone (985) 359-6694

1645 Lutcher Ave
Lutcher, LA 70071
Phone (225) 258-5901

4633 Wichers Dr
Marrero, LA 70072
Phone (504) 347-5421

1111 Medical Center Blvd
Marrero, LA 70072
Phone (504) 349-2332

1101 Medical Center Blvd
Marrero, LA 70072
Phone (504) 347-5511

4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028

3717 Houma Blvd
Ste 300
Metairie, LA 70006
Phone (504) 456-1515

2701 Lake Villa Dr
Metairie, LA 70002
Phone (504) 274-3100

4324 Veterans Memorial Blvd
Ste 102
Metairie, LA 70006

720 Veterans Memorial Blvd
Ste 100
Metairie, LA 70005
Phone (504) 293-4955

1207 N Causeway Blvd
Metairie, LA 70001
Phone (504) 832-2115

4700 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-6453

2520 Harvard Ave
Ste 2A
Metairie, LA 70001
Phone (504) 378-3668

3434 Houma Blvd
Ste 300
Metairie, LA 70006
Phone (504) 454-2017

1717 Saint Charles Ave
New Orleans, LA 70130
Phone (504) 529-6600

1401 Foucher St
New Orleans, LA 70115
Phone (504) 897-7011

200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860

2701 Napoleon Ave
New Orleans, LA 70115
Phone (504) 267-2805

Organizations & group practices 6

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 4

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1477597490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 W MICHIGAN AVE",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492011909",
            "telephone_number": "517-787-6440",
            "fax_number": "517-787-6440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3510 N CAUSEWAY BLVD STE 404",
            "city": "METAIRIE",
            "state": "LA",
            "postal_code": "700023531",
            "telephone_number": "504-779-5568"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIMELES",
        "first_name": "DEREK",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": "10645R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Metairie, LA

Sources for this page

Verify at the official NPI Registry.