NPIMap

Individual provider Active NPI

Sydney F Fussell, PA

  • Medical Physician Assistant
  • Covington, LA
National Provider Identifier
1477925196
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.200805 Issued in LA
Practice address
1203 S Tyler St Ste 100
Covington, LA 70433-2353
Phone
(985) 892-9090
Fax
(985) 892-9957
NPI assigned
Oct 21, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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.200805 LA Primary

Addresses

Primary practice location

1203 S Tyler St Ste 100
Covington, LA 70433-2353

Mailing address

4950 Essen LN
Baton Rouge, LA 70809-3738
Phone (225) 767-0847

Other practice location 1

1970 N Highway 190
Covington, LA 70433-5364
Phone (985) 400-5988

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180308000944 LA Practitioner - Physician Assistant 6709147770 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Mary Bird Perkins Cancer CenterGroup PAC ID 4385646280, 95 clinicians

Practice addresses (Care Compare)

4950 Essen LN
Baton Rouge, LA 70809-3738
Phone (225) 767-0847

Hospital & facility affiliations

  • St Tammany Parish Hospital Hospital, Covington, LA, CCN 190045
  • Riverside Medical Center Hospital, Franklinton, LA, CCN 191313
  • Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Northshore Oncology Associates, LLC CurrentSince Jan 18, 2018 Accepting new patients

Locations

1203 S Tyler St
Ste 100
Covington, LA 70433
Phone (985) 875-2234

1203 S Tyler St
Ste 230
Covington, LA 70433
Phone (985) 614-7871

4950 Essen Ln
St George, LA 70809
Phone (225) 767-0847

Organizations & group practices 4

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 10

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": "1445385600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1477925196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4950 ESSEN LN",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093738",
            "telephone_number": "225-767-0847",
            "fax_number": "225-766-0218"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 S TYLER ST STE 100",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332353",
            "telephone_number": "985-892-9090",
            "fax_number": "985-892-9957"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1970 N Highway 190",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "LA",
            "postal_code": "704335364",
            "country_code": "US",
            "telephone_number": "985-400-5988",
            "fax_number": "985-867-3644",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FUSSELL",
        "first_name": "SYDNEY",
        "middle_name": "F",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-21",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "PA.200805",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.