Individual provider Active NPI

Helena G Altick, M.D.

  • General Practice Physician
  • Monroe, LA
National Provider Identifier
1487102109
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
021333 Issued in LA
Practice address
2804 Kilpatrick Blvd
Monroe, LA 71201-5139
Phone
(318) 387-2545
NPI assigned
Sep 12, 2016
Last updated
Aug 2, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X 021333 LA Primary

Addresses

Primary practice location

2804 Kilpatrick Blvd
Monroe, LA 71201-5139

Mailing address

2804 Kilpatrick Blvd
Monroe, LA 71201-5139
Phone (318) 387-2545

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
I20200414001198 LA Practitioner - Family Practice 1254761307 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
James a Altick Jr MD a Professional Medical CorporationGroup PAC ID 8628316445, 2 clinicians

Practice addresses (Care Compare)

2804 Kilpatrick Blvd
Monroe, LA 71201-5139
Phone (318) 387-2545

Merit-based Incentive Payment System (MIPS)

Final score
0 of 100Reported as individual
Quality
0
Improvement activities
0
Cost
0

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions4070
Skin biopsy919

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
021333LAMDGeneral Practice Physician

Practice roles

OrganizationSpecialtyStatusNew patients
James a. Altick ,Jr. M.D. a Professional Medical Corporation Dermatology CurrentSince Mar 26, 2020 Accepting new patients

Locations

2804 Kilpatrick Blvd
Monroe, LA 71201
Phone (318) 387-0545

Organizations & group practices 1

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": "1473638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1690934400000",
    "number": "1487102109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2804 KILPATRICK BLVD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015139",
            "telephone_number": "318-387-2545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2804 KILPATRICK BLVD",
            "city": "MONROE",
            "state": "LA",
            "postal_code": "712015139",
            "telephone_number": "318-387-2545"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALTICK",
        "first_name": "HELENA",
        "middle_name": "G",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-09-12",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "LA",
            "license": "021333",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Monroe, LA

Sources for this page

Verify at the official NPI Registry.