NPIMap

Individual provider Active NPI

Melissa Ann Marcantel, MSN/AGNP

  • Nurse Practitioner
  • Lake Charles, LA
National Provider Identifier
1720555188
Registry record updated Oct 24, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
200587 Issued in LA
Practice address
600 Dr Michael Debakey Dr
Lake Charles, LA 70601-5727
Phone
(337) 436-3813
Fax
(337) 439-0214
NPI assigned
Oct 24, 2018
Last updated
Oct 24, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 200587 LA Primary

Addresses

Primary practice location

600 Dr Michael Debakey Dr
Lake Charles, LA 70601-5727

Mailing address

501 Dr Michael Debakey Dr
Lake Charles, LA 70601-5724
Phone (337) 436-3813

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181129000265 LA Practitioner - Nurse Practitioner 6507100724 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Imperial Health LLPGroup PAC ID 7719886779, 75 clinicians

Practice addresses (Care Compare)

600 Doctor Michael Debakey Dr
Lake Charles, LA 70601-5727
Phone (337) 436-3813

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
200587LAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Imperial Health, LLP CurrentSince Nov 1, 2018 Accepting new patients
Imperial Health LLP CurrentSince Nov 1, 2018 Accepting new patients

Locations

1322 Elton Rd
Ste H
Jennings, LA 70546
Phone (337) 246-7200

501 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 312-8258

600 Dr Michael Debakey Dr
Lake Charles, LA 70601
Phone (337) 439-5800

Interoperability endpoints

  • Direct secure messaging: melissa.marcantel@1288.direct.myezyaccess.com

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 15

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

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1720555188",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "501 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015724",
            "telephone_number": "337-436-3813",
            "fax_number": "337-439-0214"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 DR MICHAEL DEBAKEY DR",
            "city": "LAKE CHARLES",
            "state": "LA",
            "postal_code": "706015727",
            "telephone_number": "337-436-3813",
            "fax_number": "337-439-0214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MARCANTEL",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "MSN/AGNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-24",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "LA",
            "license": "200587",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake Charles, LA

Sources for this page

Verify at the official NPI Registry.