Individual provider Active NPI

Richard Gerard Palecki, D.P.M.

  • Podiatrist
  • New Roads, LA
National Provider Identifier
1639268196
Registry record updated Aug 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PodiatristTaxonomy code 213E00000X
License
PD165R Issued in LA
Practice address
230 Roberts Dr
Suite G
New Roads, LA 70760-2661
Phone
(225) 638-6640
Fax
(225) 618-0863
NPI assigned
Oct 12, 2006
Last updated
Aug 22, 2011By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatrist 213E00000X PD165R LA Primary

Addresses

Primary practice location

230 Roberts Dr
Suite G
New Roads, LA 70760-2661

Mailing address

PO Box 575
Livonia, LA 70755-0575
Phone (225) 718-5314

Other identifiers 2

IdentifierTypeStateIssuer
480026913OtherRR MCR
1668842MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Personal Care, LLC # Emerald Health Care LLC Sole MB Past Accepting new patients
Coastal Foot Clinic, a P.C. Podiatrist PastSince Jun 24, 2011 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: podiatry@inchc.directbygreenway.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1313971200000",
    "number": "1639268196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 575",
            "city": "LIVONIA",
            "state": "LA",
            "postal_code": "707550575",
            "telephone_number": "225-718-5314",
            "fax_number": "225-618-0863"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 ROBERTS DR",
            "address_2": "SUITE G",
            "city": "NEW ROADS",
            "state": "LA",
            "postal_code": "707602661",
            "telephone_number": "225-638-6640",
            "fax_number": "225-618-0863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PALECKI",
        "first_name": "RICHARD",
        "middle_name": "GERARD",
        "name_prefix": "Dr.",
        "credential": "D.P.M.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2011-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "LA",
            "license": "PD165R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MCR",
            "identifier": "480026913",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1668842",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Roads, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.