NPIMap

Organization Active NPI

Lake Surgical Hospital Slidell, LLC

Doing business as Southern Surgical Hospital

  • General Acute Care Hospital
  • Slidell, LA
National Provider Identifier
1821465576
Registry record updated Jan 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Acute Care HospitalTaxonomy code 282N00000X
Legal business name
LAKE SURGICAL HOSPITAL SLIDELL, LLC
Doing business as
Southern Surgical Hospital
Practice address
1700 Lindberg Dr
Slidell, LA 70458-8062
Phone
(985) 661-2105
Fax
(985) 643-7677
NPI assigned
Aug 28, 2015
Last updated
Jan 10, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2024

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

Authorized official

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

Specialties & licenses 1

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

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 1

  • Southern Surgical Hospital Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address noreply@sshlamsg.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA

Enrollment records 1

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

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1821465576. Details of each certification follow.

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
LLCProprietary
Incorporated
Oct 1, 2015 in LA
Enrollment address
1700 Lindberg Dr
Slidell, LA 70458-8062
Main/Primary Hospital Location
Hospital subgroups
Acute care

Care Compare: Hospital

Medicare Care Compare
Listed as
Our Lady of the Lake Surgical HospitalCCN 190270 · All quality measures
Type
Acute Care Hospitals
Ownership
Physician
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
No

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
19D1043171Our Lady of the Lake Surgical Hospital1700 Lindberg Drive, Slidell, LA 70458AccreditationDec 7, 2026

National Provider Directory

National Provider Directory
Tax ID family
Our Lady of the Lake Re10 organizations share this tax ID, including this one

Other organizations with this 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.

Interoperability endpoints

  • Direct secure messaging: noreply@sshlamsg.com

Ownership & related parties

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 OfficerOfficer Aug 1, 2020
W-2 Managing EmployeeCeo Oct 1, 2015

Owners & managing parties with NPI records 3

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

Facilities with the same owner 12

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

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.

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

Affiliated clinicians 56

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

View all 56

NPI Registry JSON

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704844800000",
    "number": "1821465576",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1700 LINDBERG DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704588062",
            "telephone_number": "985-661-2105",
            "fax_number": "985-643-7677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1700 LINDBERG DR",
            "city": "SLIDELL",
            "state": "LA",
            "postal_code": "704588062",
            "telephone_number": "985-661-2105",
            "fax_number": "985-643-7677"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE SURGICAL HOSPITAL SLIDELL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-28",
        "last_updated": "2024-01-10",
        "certification_date": "2024-01-10",
        "status": "A",
        "authorized_official_last_name": "PISCIOTTA",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "985-641-0600"
    },
    "taxonomies": [
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "noreply@sshlamsg.com",
            "affiliation": "N",
            "endpointDescription": "Direct Email Address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "1700 Lindberg Dr",
            "city": "Slidell",
            "state": "LA",
            "country_code": "US",
            "postal_code": "704588062",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "Southern Surgical Hospital",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Southern Surgical Hospital",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Slidell, LA

Sources for this page

Verify at the official NPI Registry.