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Lake Surgical Hospital Slidell, LLC

Organization Active NPI General Acute Care Hospital · Slidell, LA

NPI 1821465576 · NPPES record last updated Jan 10, 2024

Key facts

NPI
1821465576
Entity type
Organization (NPI type 2)
Primary specialty
General Acute Care Hospital 282N00000X
Legal business name
LAKE SURGICAL HOSPITAL SLIDELL, LLC
Practice address
1700 Lindberg Dr
Slidell, LA 70458-8062
Phone
(985) 661-2105
Fax
(985) 643-7677
NPI assigned
Aug 28, 2015
Organization subpart
No

Authorized official

Name
Michael Pisciotta
Title
Authorized Official
Phone
(985) 641-0600

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Subparts reporting this organization as parent 2

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Corporate family (same tax ID) 9

Organizations that report the same tax identification number in the National Provider Directory.

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Facilities with the same owner 12

Facilities that share an organizational owner with 5% or greater ownership or operational control.

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Affiliated clinicians 56

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 56

Medicare Care Compare: Hospital

Listed as
Our Lady of the Lake Surgical Hospital CCN 190270
Type
Acute Care Hospitals
Ownership
Physician
Medicare certification status
Active (Provider of Services file)
Emergency services
No

Source: Medicare Care Compare.

Laboratory certificates & supplier records

Name & address match These CMS records do not include an NPI. They are shown here because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1043171Our Lady of the Lake Surgical Hospital
1700 Lindberg Drive, Slidell, LA 70458		AccreditationDec 7, 2026

Medicare participation

Medicare fee-for-service enrollment
Enrolled in LA

Hospital certification: CCN 190270

Legal name
LAKE SURGICAL HOSPITAL SLIDELL LLC
Doing business as
OUR LADY OF THE LAKE SURGICAL HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Short-term
Participating since
Nov 4, 2005
Last certification
Aug 11, 2023
Beds
37
Ownership / control type
Physician ownership
Most recent change of ownership
Oct 1, 2015 (2 total)
Organization structure
LLC · Proprietary
Incorporated
Oct 1, 2015 in LA
Enrollment address
1700 Lindberg Dr
Slidell, LA 70458-8062
Main/Primary Hospital Location
Hospital subgroups
Acute care

All disclosed owners & managing parties 2

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Our Lady of the Lake Hospital Inc
Organization · Baton Rouge, LA
Corporation 		5% Or Greater Indirect Ownership Interest Oct 1, 2015 33.06%
Michael Pisciotta
Individual 		Corporate Officer
Officer		 Aug 1, 2020
W-2 Managing Employee
Ceo		 Oct 1, 2015

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20160215000880 LA Part a Provider - Hospital 9638473432 Practice locations: Slidell, LA

National Provider Directory

Tax ID family
Industrial Family Medic (10 organizations share this tax ID)

Interoperability endpoints

  • Direct secure messaging: noreply@sshlamsg.com

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Acute Care Hospital 282N00000X Yes

Addresses

Primary practice location

1700 Lindberg Dr
Slidell, LA 70458-8062

Mailing address

1700 Lindberg Dr
Slidell, LA 70458-8062
Phone (985) 661-2105

Other names

  • Southern Surgical Hospital Doing business as

Electronic endpoints

TypeEndpointUseAffiliation
Direct Messaging Address noreply@sshlamsg.com Direct

Other providers in Slidell, LA

All providers in Slidell, LA · General Acute Care Hospital in Louisiana

Sources for this page

Verify at the official NPI Registry.