Individual provider Active NPI

Nicholas Joseph Viviano, MD

  • Procedural Dermatology Physician
  • Covington, LA
National Provider Identifier
1730187162
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Procedural Dermatology PhysicianTaxonomy code 207NS0135X
License
015859 Issued in LA
Practice address
7031 Highway 190
Covington, LA 70433-4955
Phone
(985) 893-9464
NPI assigned
Jul 11, 2005
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Procedural Dermatology Physician 207NS0135X 015859 LA Primary

Addresses

Primary practice location

7031 Highway 190
Covington, LA 70433-4955

Mailing address

PO Box 1259
Mandeville, LA 70470-1259
Phone (985) 893-9464

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
I20040421000255 LA Practitioner - Dermatology 8628063328 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Tulane University School of Medicine, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

7031 Hwy 190 E Service Rd
Dermatology Clinic of Mandeville
Covington, LA 70433-4955
Phone (985) 893-9464

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision58
Removal of skin lesions77
Skin biopsy74

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
015859LAMDProcedural Dermatology Physician

Organizations & group practices 1

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": "1121040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1730187162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1259",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704701259",
            "telephone_number": "985-893-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7031 HIGHWAY 190",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704334955",
            "telephone_number": "985-893-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIVIANO",
        "first_name": "NICHOLAS",
        "middle_name": "JOSEPH",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-07-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207NS0135X",
            "taxonomy_group": "",
            "desc": "Dermatology, Procedural Dermatology",
            "state": "LA",
            "license": "015859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.