Individual provider Active NPI

Robert J Grieshaber, MD

  • Dermatology Physician
  • Covington, LA
National Provider Identifier
1881731222
Registry record updated Jun 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Dermatology PhysicianTaxonomy code 207N00000X
License
014156 Issued in LA
Practice address
714 W 16TH Ave
Covington, LA 70433-2422
Phone
(985) 893-1035
Fax
(985) 893-1058
NPI assigned
Feb 1, 2007
Last updated
Jun 20, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatology Physician 207N00000X 014156 LA Primary

Addresses

Primary practice location

714 W 16TH Ave
Covington, LA 70433-2422

Mailing address

714 W 16TH Ave
Covington, LA 70433-2422
Phone (985) 893-1035

Other identifiers 1

IdentifierTypeStateIssuer
014156OtherLALA MEDICAL LISC

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
I20120410000729 LA Practitioner - Dermatology 1456512987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Dermatology
Education
Louisiana State University School of Medicine in New Orleans, 1977
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Dermatology Clinic of St. Tammany II, LLCGroup PAC ID 2769814599, 4 clinicians

Practice addresses (Care Compare)

714 W 16TH Ave
Covington, LA 70433-2422
Phone (985) 893-1035

Merit-based Incentive Payment System (MIPS)

Final score
97.47 of 100Reported as group
Quality
94.94
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1112
Removal or shaving of skin growth51
Skin biopsy26

National Provider Directory

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

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170288000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340150400000",
    "number": "1881731222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "714 W 16TH AVE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332422",
            "telephone_number": "985-893-1035",
            "fax_number": "985-893-1058"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "714 W 16TH AVE",
            "city": "COVINGTON",
            "state": "LA",
            "postal_code": "704332422",
            "telephone_number": "985-893-1035",
            "fax_number": "985-893-1058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRIESHABER",
        "first_name": "ROBERT",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-02-01",
        "last_updated": "2012-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "014156",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LA MEDICAL LISC",
            "identifier": "014156",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Covington, LA

Sources for this page

Verify at the official NPI Registry.