NPIMap

Organization Active NPI

Cenla Dermatology

  • Dermatology Physician
  • Alexandria, LA
National Provider Identifier
1851919005
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
Legal business name
CENLA DERMATOLOGY
Practice address
1587 N Bolton Ave Ste 1300
Alexandria, LA 71303-4255
Phone
(318) 933-3376
Fax
(318) 933-3377
NPI assigned
Jul 13, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Authorized official

Name
Mrs. Lisa Martinez
Title
Coordinator
Phone
(615) 424-5357

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207N00000X Primary

Addresses

Primary practice location

1587 N Bolton Ave Ste 1300
Alexandria, LA 71303-4255

Mailing address

1587 N Bolton Ave Ste 1300
Alexandria, LA 71303-4255
Phone (615) 424-5357

Other names 1

  • Cenla Dermatology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200930001107 LA Part B Supplier - Clinic/Group Practice 0446679161 Receives reassigned benefits from 6 practitioners
Practice locations: Alexandria, LA

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
19D2190442Cenla Dermatology1587 N Bolton Ave,#1300, Alexandria, LA 71303ComplianceJan 25, 2028

National Provider Directory

National Provider Directory

Locations

1587 N Bolton Ave
Ste 1300
Alexandria, LA 71303
Phone 3184439773400

Practitioners & affiliated clinicians

Practitioners 7

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

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594598400000",
    "number": "1851919005",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1587 N BOLTON AVE STE 1300",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713034255",
            "telephone_number": "615-424-5357",
            "fax_number": "318-933-3377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1587 N BOLTON AVE STE 1300",
            "city": "ALEXANDRIA",
            "state": "LA",
            "postal_code": "713034255",
            "telephone_number": "318-933-3376",
            "fax_number": "318-933-3377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENLA DERMATOLOGY",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A",
        "authorized_official_last_name": "MARTINEZ",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "COORDINATOR",
        "authorized_official_telephone_number": "615-424-5357",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dermatology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Cenla Dermatology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Alexandria, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.