NPIMap

Organization Active NPI

Pontchartrain Surgery Center, LLC

  • Ambulatory Surgical Clinic/Center
  • Covington, LA
National Provider Identifier
1497090740
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Ambulatory Surgical Clinic/CenterTaxonomy code 261QA1903X
License
157 Issued in LA
Legal business name
PONTCHARTRAIN SURGERY CENTER, LLC
Practice address
4407 Highway 190 East Service Rd
Ste 200
Covington, LA 70433-4957
Phone
(985) 234-9700
Fax
(985) 234-9706
NPI assigned
Nov 27, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Authorized official

Name
Lisa Salmon, RN
Title
Administrator
Phone
(985) 234-9700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Ambulatory Surgical Clinic/Center 261QA1903X 157 LA Primary

Addresses

Primary practice location

4407 Highway 190 East Service Rd
Ste 200
Covington, LA 70433-4957

Mailing address

4407 Highway 190 East Service Rd Ste 200
Covington, LA 70433-4972
Phone (985) 234-9700

Other names 2

  • Our Lady of the Lake Pontchartrain Surgery Center Doing business as
  • Pontchartrain Surgery Center, LLC Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130716000179 LA Part B Supplier - Ambulatory Surgical Center 0648410605 Receives reassigned benefits from 22 practitioners
Practice locations: Covington, LA

Care Compare: Ambulatory surgical center

Medicare Care Compare
Listed as
Olol Pontchartrain Surgery Center LLC Dba Our Lady of the Lake Pontchartrain Surgery CenterCCN 19C0001113
Medicare certification status
ActiveFrom the Provider of Services file

National Provider Directory

National Provider Directory

Member of 3

Organizations this organization is a member of, according to the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 23

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1353974400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1761609600000",
    "number": "1497090740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4407 HIGHWAY 190 EAST SERVICE RD STE 200",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704334972",
            "telephone_number": "985-234-9700",
            "fax_number": "985-234-9706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4407 HIGHWAY 190 EAST SERVICE RD",
            "address_2": "STE 200",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704334957",
            "telephone_number": "985-234-9700",
            "fax_number": "985-234-9706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PONTCHARTRAIN SURGERY CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-27",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A",
        "authorized_official_last_name": "SALMON",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "985-234-9700",
        "authorized_official_credential": "RN"
    },
    "taxonomies": [
        {
            "code": "261QA1903X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Ambulatory Surgical",
            "state": "LA",
            "license": "157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Our Lady of the Lake Pontchartrain Surgery Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Pontchartrain Surgery Center, LLC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Covington, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.