Active NPI
Richard J. Grisoli, M.D.
- Anesthesiology Physician
- Hammond, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 016201
- Practice address
- 15790 Paul Vega MD Dr
Hammond, LA 70403-1434 - Phone
- (985) 345-8867
- Fax
- (985) 542-5322
- NPI assigned
- Jun 16, 2005
- Last updated
- Apr 24, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 016201 | LA | Primary |
| Critical Care Medicine (Anesthesiology) Physician | 207LC0200X | 016201 | LA | |
| Phlebology Physician | 202K00000X | ME92186 | FL |
Addresses
Primary practice location
15790 Paul Vega MD Dr
Hammond, LA 70403-1434
Mailing address
93 Bogue Falaya Dr
Covington, LA 70433-4303
Phone (985) 230-6688
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1337781 | Medicaid | LA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in LA, FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 3
Care Compare profile
Medicare Care Compare- Specialty
- Critical Care (Intensivists)
- Education
- Other, 1981
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
220 Dalwill Dr
Suite 102
Mandeville, LA 70471-3482
Phone (985) 507-9116
Procedures performed for Medicare patients
| Procedure | Number of procedures |
|---|---|
| Varicose vein removal | 61 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 16201 | LA | MD | Pharmacist |
| 016201 | LA | MD | Critical Care Medicine (Anesthesiology) Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Northshore Laser & Vein Center LLC | Current | Accepting new patients | |
| Cardiovascular and Thoracic Surgeons of the South, LLC | Current | Accepting new patients | |
| Laurence Michael May, MD, Apmc | Anesthesiology | Past | Accepting new patients |
| Vein Clinics of Hawaii LLC | Past | Accepting new patients | |
| North Oaks Anesthesiology Associates LLC | Anesthesiology | Past | Accepting new patients |
Locations
220 Dalwill Dr
Ste 102
Mandeville, LA 70471
Phone (985) 507-9116
4080 Lonesome Rd
Ste A
Mandeville, LA 70448
Phone (985) 892-2950
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.
-
- Critical Care Medicine (Internal Medicine) Physician
- Mandeville, LA
- NPI 1205516903
-
- Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
- Covington, LA
- NPI 1215070503
-
- Anesthesiology Physician
- Hammond, LA
- NPI 1649479676
-
- Anesthesiology Physician
- Hammond, LA
- NPI 1154326767
-
- Vascular Surgery Physician
- Kamuela, HI
- NPI 1528307006
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1492992000000",
"number": "1568467413",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "93 BOGUE FALAYA DR",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704334303",
"telephone_number": "985-230-6688",
"fax_number": "985-230-6176"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15790 PAUL VEGA MD DR",
"city": "HAMMOND",
"state": "LA",
"postal_code": "704031434",
"telephone_number": "985-345-8867",
"fax_number": "985-542-5322"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRISOLI",
"first_name": "RICHARD",
"middle_name": "J.",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-06-16",
"last_updated": "2017-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "LA",
"license": "016201",
"primary": true
},
{
"code": "207LC0200X",
"taxonomy_group": "",
"desc": "Anesthesiology, Critical Care Medicine",
"state": "LA",
"license": "016201",
"primary": false
},
{
"code": "202K00000X",
"taxonomy_group": "",
"desc": "Phlebology",
"state": "FL",
"license": "ME92186",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1337781",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Hammond, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.