Individual provider Active NPI

Degan Joseph Dansereau, M.D.

  • Psychiatry Physician
  • New Orleans, LA
National Provider Identifier
1700846458
Registry record updated Feb 22, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
024911 Issued in LA
Practice address
3705 Coliseum St
New Orleans, LA 70115-3708
Phone
(504) 897-0201
NPI assigned
Mar 26, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X 024911 LA Primary

Addresses

Primary practice location

3705 Coliseum St
New Orleans, LA 70115-3708

Mailing address

3705 Coliseum St
New Orleans, LA 70115-3708
Phone (504) 897-0201

Other identifiers 1

IdentifierTypeStateIssuer
1424056MedicaidLA

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
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040918000020 LA Practitioner - Psychiatry 4880662857 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Louisiana State University School of Medicine in New Orleans, 2000
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3705 Coliseum St
New Orleans, LA 70115-3708
Phone (504) 897-0201

95 Fairway Dr
Covington, LA 70433-4969
Phone (985) 867-3800

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
024911LAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Degan J Dansereau MD LLC Psychiatry CurrentSince Oct 31, 2005 Accepting new patients

Locations

95 Judge Tanner Blvd
Covington, LA 70433
Phone (504) 867-3800

195 Highland Park Entrance
Covington, LA 70433
Phone (985) 867-3977

3705 Coliseum St
New Orleans, LA 70115
Phone (504) 891-0094

3705 Coliseum St
Ste 3
New Orleans, LA 70115
Phone (504) 897-0201

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143331200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203638400000",
    "number": "1700846458",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3705 COLISEUM ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701153708",
            "telephone_number": "504-897-0201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3705 COLISEUM ST",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701153708",
            "telephone_number": "504-897-0201"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANSEREAU",
        "first_name": "DEGAN",
        "middle_name": "JOSEPH",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-03-26",
        "last_updated": "2008-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "024911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1424056",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Orleans, LA

Sources for this page

Verify at the official NPI Registry.