Individual provider Active NPI

Mary Diane Rabalais, WHNP

  • Women's Health Nurse Practitioner
  • Hammond, LA
National Provider Identifier
1740622638
Registry record updated Dec 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
AP07283 Issued in LA
Practice address
15813 Paul Vega MD Dr Ste 200
Hammond, LA 70403-1431
Phone
(985) 230-7650
Fax
(985) 230-7655
NPI assigned
Jul 22, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 30, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X AP07283 LA Primary

Addresses

Primary practice location

15813 Paul Vega MD Dr Ste 200
Hammond, LA 70403-1431

Mailing address

PO Box 2668
Hammond, LA 70404-2668
Phone (985) 230-7650

Other identifiers 2

IdentifierTypeStateIssuer
03976556MedicaidMS
2374125MedicaidLA

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL https://soapproxyprd.northoaks.org/nohsfhir/api/FHIR/R4/ North Oaks Physician Group, LLC

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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141017000591 LA Practitioner - Nurse Practitioner 3274754163 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
North Oaks Medical Center LLCGroup PAC ID 2466629522, 317 clinicians

Practice addresses (Care Compare)

15813 Paul Vega MD Dr
Suite 200
Hammond, LA 70403-1431
Phone (985) 230-7650

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
86.91 of 100Reported as group
Quality
78.17
Promoting interoperability
100
Improvement activities
40
Cost
67.71

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP07283LAMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
North Oaks Physician Group, LLC CurrentSince Sep 8, 2020 Accepting new patients
North Oaks Medical Center, LLC CurrentSince Jun 5, 2022 Accepting new patients
Ochsner Clinic LLC Past Accepting new patients

Locations

15813 Paul Vega Md Dr
Hammond, LA 70403

15784 Medical Arts Dr
Hammond, LA 70403

15813 Paul Vega Md Dr
Ste 200
Hammond, LA 70403
Phone (985) 230-7650

15790 Paul Vega Md Dr
Hammond, LA 70403
Phone (985) 230-1682

17199 Spring Ranch Rd
Ste 210G
Livingston, LA 70754
Phone (225) 686-4960

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 and National Provider Directory roles.

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": "1374451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1672358400000",
    "number": "1740622638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2668",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704042668",
            "telephone_number": "985-230-7650",
            "fax_number": "985-230-7655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15813 PAUL VEGA MD DR STE 200",
            "city": "HAMMOND",
            "state": "LA",
            "postal_code": "704031431",
            "telephone_number": "985-230-7650",
            "fax_number": "985-230-7655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABALAIS",
        "first_name": "MARY",
        "middle_name": "DIANE",
        "name_prefix": "Mrs.",
        "credential": "WHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-22",
        "last_updated": "2022-12-30",
        "certification_date": "2022-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "LA",
            "license": "AP07283",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03976556",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2374125",
            "state": "LA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://soapproxyprd.northoaks.org/nohsfhir/api/FHIR/R4/",
            "affiliation": "Y",
            "affiliationName": "North Oaks Physician Group, LLC",
            "address_1": "15813 Paul Vega Md Dr Ste 200",
            "city": "Hammond",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704031431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Hammond, LA

Sources for this page

Verify at the official NPI Registry.