Active NPI
Kraig S De Lanzac, M.D.
- Anesthesiology Physician
- Slidell, LA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Anesthesiology Physician
- License
- 10512R
- Practice address
- 1001 Gause Blvd
Slidell, LA 70458-2939 - Phone
- (985) 649-8767
- NPI assigned
- May 30, 2005
- Last updated
- Dec 8, 2007
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Anesthesiology Physician | 207L00000X | 10512R | LA | Primary |
Addresses
Primary practice location
1001 Gause Blvd
Slidell, LA 70458-2939
Mailing address
120 Innwood Dr
Covington, LA 70433-9123
Phone (985) 892-3225
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1490075 | Medicaid | LA |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Anesthesiology
- Education
- Louisiana State University School of Medicine in New Orleans, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4700 S I 10 Service Rd W
Tulane Lakeside Hospital
Metairie, LA 70001-1210
Phone (504) 613-0711
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10512R | LA | MD | Anesthesiology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Administrators of the Tulane Educational Fund | Current | Accepting new patients | |
| Administrators of the Tulane Educational Fund | Current | Accepting new patients | |
| Childrens Hospital Anesthesia Corporation | Anesthesiology | Current | Accepting new patients |
| Zephyr Anesthesia, LLC | Anesthesiology | Current | Accepting new patients |
Locations
694 Belle Terre Blvd
La Place, LA 70068
Phone (985) 359-6694
4200 Houma Blvd
Metairie, LA 70006
Phone (504) 454-4028
4700 S I 10 Svc Rd W
Metairie, LA 70001
Phone (504) 780-6453
1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300
1532 Tulane Ave
New Orleans, LA 70112
Phone (504) 585-6485
200 Henry Clay Ave
New Orleans, LA 70118
Phone (504) 412-1860
2021 Perdido St
New Orleans, LA 70112
Phone (504) 412-1800
2701 Napoleon Ave
New Orleans, LA 70115
Phone (504) 267-2805
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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba LCMC Anesthesia
- Anesthesiology Physician
- New Orleans, LA
- NPI 1649362740
-
dba Tulane University Medical Group
- Specialist
- New Orleans, LA
- NPI 1528014164
-
- Anesthesiology Physician
- La Place, LA
- NPI 1891087458
-
- Specialist
- Hattiesburg, MS
- NPI 1033395298
Hospital & facility affiliations 4
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- New Orleans, LA
- NPI 1033611454
-
dba East Jefferson General Hospital
- General Acute Care Hospital
- Metairie, LA
- NPI 1497792527
-
dba Lakeview Regional Behavioral Health
- Psychiatric Hospital Unit
- Covington, LA
- NPI 1790722825
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117411200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1197072000000",
"number": "1609879139",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "120 INNWOOD DR",
"city": "COVINGTON",
"state": "LA",
"postal_code": "704339123",
"telephone_number": "985-892-3225"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1001 GAUSE BLVD",
"city": "SLIDELL",
"state": "LA",
"postal_code": "704582939",
"telephone_number": "985-649-8767"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DE LANZAC",
"first_name": "KRAIG",
"middle_name": "S",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-05-30",
"last_updated": "2007-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "207L00000X",
"taxonomy_group": "",
"desc": "Anesthesiology",
"state": "LA",
"license": "10512R",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1490075",
"state": "LA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Slidell, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2007; 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.