Individual provider Active NPI

Laura Toups Hetzler, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Baton Rouge, LA
National Provider Identifier
1740446228
Registry record updated Mar 25, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
MD.204078 Issued in LA
Practice address
4950 Essen LN Ste 400
Baton Rouge, LA 70809-3738
Phone
(225) 765-1765
Fax
(225) 765-1768
NPI assigned
Aug 4, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 125049497 IL
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X MD.204078 LA Primary

Addresses

Primary practice location

4950 Essen LN Ste 400
Baton Rouge, LA 70809-3738

Mailing address

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816-6038
Phone (225) 765-5727

Other identifiers 1

IdentifierTypeStateIssuer
1067814MedicaidLA

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
I20101026000501 LA Practitioner - Otolaryngology 2961554597 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Otolaryngology
Education
Louisiana State University School of Medicine in New Orleans, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4950 Essen LN
Suite 400
Baton Rouge, LA 70809-3738
Phone (225) 765-1765

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision14
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
125049497ILMDSpecialist
MD.204078LAMDOtolaryngology/Facial Plastic Surgery Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Our Lady of the Lake Physician Group LLC CurrentSince Jul 2, 2012 Accepting new patients
Our Lady of the Lake Physician Group LLC Otolaryngology CurrentSince Jul 2, 2012 Accepting new patients
Our Lady of the Lake Physician Group LLC Past Accepting new patients

Locations

7777 Hennessy Blvd
Ste 709
Baton Rouge, LA 70808
Phone (225) 765-7735

5959 S Sherwood Forest Blvd
Baton Rouge, LA 70816
Phone (225) 526-0011

4950 Essen Ln
Ste 400
Baton Rouge, LA 70809
Phone (225) 765-1765

9032 Perkins Rd
Baton Rouge, LA 70810
Phone (225) 358-4853

Organizations & group practices 4

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 1

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

NPI Registry JSON

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

{
    "created_epoch": "1217808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616630400000",
    "number": "1740446228",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 S SHERWOOD FOREST BLVD",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708166038",
            "telephone_number": "225-765-5727",
            "fax_number": "225-765-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4950 ESSEN LN STE 400",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093738",
            "telephone_number": "225-765-1765",
            "fax_number": "225-765-1768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HETZLER",
        "first_name": "LAURA",
        "middle_name": "TOUPS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-08-04",
        "last_updated": "2021-03-25",
        "certification_date": "2021-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IL",
            "license": "125049497",
            "primary": false
        },
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "LA",
            "license": "MD.204078",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1067814",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.