Individual provider Active NPI

Nicole Elaine Fiske, D.O.

  • Emergency Medicine Physician
  • Baton Rouge, LA
National Provider Identifier
1790052397
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DO.000464 Issued in LA
Practice address
7777 Hennessy Blvd Ste 211
Baton Rouge, LA 70808-4365
Phone
(225) 765-7163
Fax
(225) 765-7164
NPI assigned
Nov 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X OH
Emergency Medicine Physician 207P00000X DO.000464 LA Primary

Addresses

Primary practice location

7777 Hennessy Blvd Ste 211
Baton Rouge, LA 70808-4365

Mailing address

7777 Hennessy Blvd Ste 211
Baton Rouge, LA 70808-4365
Phone (225) 765-7163

Other practice location 1

405 W Grand Ave
Dayton, OH 45405-4720
Phone (937) 723-3200

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
I20151117000879 LA Practitioner - Emergency Medicine 6406094481 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Ohio University, College of Osteopathic Medicine, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mayfair Emergency Group, LLCGroup PAC ID 3375808645, 33 clinicians

Practice addresses (Care Compare)

17000 Medical Ctr Dr
Baton Rouge, LA 70816-3246
Phone (225) 752-2470

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.76 of 100Reported as group
Quality
87.95
Improvement activities
40

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Mayfair Emergency Group, LLC Emergency Medicine CurrentSince Nov 14, 2022 Accepting new patients
Main Street Emergency Group LLC Emergency Medicine CurrentSince Aug 26, 2015 Accepting new patients
Acs Primary Care Physicians Louisiana PC Emergency Medicine CurrentSince Mar 1, 2016 Accepting new patients
Professional Emergency Physician Associates, LLC Emergency Medicine CurrentSince Feb 14, 2017 Accepting new patients
East Baton Rouge Emergency Physicians Group, LLC Emergency Medicine CurrentSince Aug 1, 2020 Accepting new patients

Locations

Dept AT952639
Atlanta, GA 31192

211 4th St
Alexandria, LA 71301
Phone (318) 473-3000

17000 Medical Center Dr
Baton Rouge, LA 70816
Phone (225) 752-2470

5000 Hennessy Blvd
Baton Rouge, LA 70808
Phone (225) 765-4050

2315 E Main St
New Iberia, LA 70560
Phone (337) 364-0441

25455 Highway 1
Plaquemine, LA 70764
Phone (225) 754-6870

37358 Market Place Dr
Prairieville, LA 70769
Phone (225) 755-9765

6300 Main St
Zachary, LA 70791
Phone (225) 570-2618

Organizations & group practices 5

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": "1322352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1790052397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 211",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084365",
            "telephone_number": "225-765-7163",
            "fax_number": "225-765-7164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7777 HENNESSY BLVD STE 211",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708084365",
            "telephone_number": "225-765-7163",
            "fax_number": "225-765-7164"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "405 W Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Dayton",
            "state": "OH",
            "postal_code": "454054720",
            "country_code": "US",
            "telephone_number": "937-723-3200",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FISKE",
        "first_name": "NICOLE",
        "middle_name": "ELAINE",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": null,
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "LA",
            "license": "DO.000464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.