Glenda Carol Breakfell Petroff, FNPC

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN099641AP03834 Issued in LA

Practice address

22070 Highway 59
Abita Springs, LA 70420

Phone

(985) 892-0879

Fax

(985) 875-2384

NPI assigned

May 23, 2005

Reactivated

May 24, 2005

Last updated

Jan 28, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

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

Specialty

Nurse Practitioner

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Elara Caring Home health agency, Hammond, LA, CCN 197778
• Ochsner Medical Center Acute Hospital, New Orleans, LA, CCN 190036
• St Tammany Parish Hospital Hospital, Covington, LA, CCN 190045
• Slidell Memorial Hospital Hospital, Slidell, LA, CCN 190040

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: gpetroff3571@direct.ochsner.org

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.

• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  Medicare reassignment Care Compare group NPD
• Ochsner Clinic LLC

  dba Diabetes Prevention Program

  • Registered Dietitian
  • Covington, LA
  • NPI 1013747039
  NPD
• Ochsner Clinic LLC

  dba Ochsner Health Center Baton Rouge

  • General Practice Physician
  • Baton Rouge, LA
  • NPI 1689872616
  NPD
• M a Culasso, LLC

  • Family Medicine Physician
  • Slidell, LA
  • NPI 1083617237
  NPD (past)
• Ochsner Clinic LLC

  dba Ochsner Clinic LLC (BR)

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1407848443
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Excel Home Health Services, Inc

  dba Elara Caring

  • Home Health Agency
  • Hammond, LA
  • NPI 1972627909
  Care Compare affiliation
• Ochsner Clinic Foundation

  dba Ochsner Medical Center Acute

  • General Acute Care Hospital
  • New Orleans, LA
  • NPI 1811973100
  Care Compare affiliation
• Slidell Memorial Hospital

  • General Acute Care Hospital
  • Slidell, LA
  • NPI 1578568481
  Care Compare affiliation
• St Tammany Parish Hospital Service District No 1

  dba St Tammany Physicians Network

  • Internal Medicine Physician
  • Covington, LA
  • NPI 1083793582

  Hospital

  Care Compare affiliation
• St Tammany Parish Hospital Service District No 1

  dba Northlake Pulmonary Associates at St Tammany Parish Hospital

  • Pulmonary Disease Physician
  • Covington, LA
  • NPI 1285285874

  Hospital

  Care Compare affiliation
• St. Tammany Parish Hospital Service District No 1

  dba St. Tammany Parish Hospital

  • General Acute Care Hospital
  • Covington, LA
  • NPI 1598798597
  Care Compare affiliation

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

{
    "created_epoch": "1116806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1201478400000",
    "number": "1609879659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "70121",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22070 HIGHWAY 59",
            "city": "ABITA SPRINGS",
            "state": "LA",
            "postal_code": "70420",
            "telephone_number": "985-892-0879",
            "fax_number": "985-875-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETROFF",
        "first_name": "GLENDA",
        "middle_name": "CAROL BREAKFELL",
        "credential": "FNPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-05-23",
        "last_updated": "2008-01-28",
        "deactivation_date": "2005-05-23",
        "reactivation_date": "2005-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "RN099641AP03834",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "LA",
            "license": "RN099641",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00239061",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1128139",
            "state": "LA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "07931777",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ochsner Clinic LLC (Ochsner Health Center - Abita Springs)
• Ochsner Clinic LLC (Ochsner Health Center Abita Springs)
• Optimal Therapy Solutions, LLC
• Miranda Irene Paine-Jesam, MT-BC
• Joseph Seth Paul
• Michael Joseph Petrosky, DC
• Tessa Price, YOGA SPECIALIST
• Primary Nutrition Consulting LLC
• Philip J. Puneky, D.D.S.
• Katherine Quayhagen, C-IAYT

• Nurse Practitioner in Abita Springs, LA
• Providers in Abita Springs, LA by specialty
• Nurse Practitioner in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2008; 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.

Verify at the official NPI Registry.