Individual provider Active NPI

Misty Melerine Breakfield, PA

  • Medical Physician Assistant
  • Covington, LA
National Provider Identifier
1508854993
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA.200060.RX Issued in LA
Practice address
56 Starbrush Cir
Covington, LA 70433-7208
Phone
(985) 246-5670
Fax
(985) 246-5667
NPI assigned
Oct 10, 2005
Last updated
Oct 2, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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.200060.RX LA Primary

Addresses

Primary practice location

56 Starbrush Cir
Covington, LA 70433-7208

Mailing address

56 Starbrush Cir
Covington, LA 70433-7208
Phone (985) 246-5670

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
I20090425000005 LA Practitioner - Physician Assistant 0941224208 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tchefuncte Health and Wellness, LLCGroup PAC ID 5698061711, 3 clinicians

Practice addresses (Care Compare)

56 Starbrush Cir
Covington, LA 70433-7208
Phone (985) 246-5670

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
PA.200060.RXLAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC CurrentSince Apr 9, 2009 Accepting new patients
Ochsner Clinic LLC CurrentSince Apr 9, 2009 Accepting new patients
Bopp Dermatology and Facial Plastic Surgery Past Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

1514 Jefferson Hwy
New Orleans, LA 70121

2750 Gause Blvd E
Slidell, LA 70461

Organizations & group practices 5

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.

Hospital & facility affiliations 3

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": "1128902400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1508854993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "56 STARBRUSH CIR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337208",
            "telephone_number": "985-246-5670",
            "fax_number": "985-246-5667"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "56 STARBRUSH CIR",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704337208",
            "telephone_number": "985-246-5670",
            "fax_number": "985-246-5667"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREAKFIELD",
        "first_name": "MISTY",
        "middle_name": "MELERINE",
        "name_prefix": "Ms.",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-10",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "LA",
            "license": "PA.200060.RX",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.