Individual provider Active NPI

Robert Detrinis, M.D.

  • Psychiatry Physician
  • Daphne, AL
National Provider Identifier
1891734455
Registry record updated Oct 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
MD.44998 Issued in AL
Practice address
7400 Roper LN
Daphne, AL 36526-5274
Phone
(251) 450-2211
NPI assigned
Jun 6, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician 2084P0800X LA9582R LA
Psychiatry Physician 2084P0800X MD.44998 AL Primary

Addresses

Primary practice location

7400 Roper LN
Daphne, AL 36526-5274

Mailing address

5750A Southland Dr
Mobile, AL 36693-3316
Phone (251) 450-5916

Other identifiers 1

IdentifierTypeStateIssuer
1962520MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA, AL2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20051215000513 LA Practitioner - Psychiatry 1254352446 Reassigns benefits to 2 organizations
I20221015000020 AL Practitioner - Psychiatry 1254352446 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MD.44998ALMDPsychiatry Physician
LA9582RLAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Altapointe Health Systems, Inc. CurrentSince Oct 3, 2022 Accepting new patients
South Central la Human Services Authority CurrentSince Nov 11, 2014 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Sep 30, 2014 Accepting new patients
Administrators of the Tulane Educational Fund CurrentSince Sep 30, 2014 Accepting new patients
South Central la Human Services Authority CurrentSince Nov 11, 2014 Accepting new patients
Altapointe Health Systems, Inc. CurrentSince Oct 3, 2022 Accepting new patients
Altapointe Health Systems Inc Past Accepting new patients
Tulane School Department of Psychiatry Past Accepting new patients

Locations

7400 Roper Ln
Daphne, AL 36526
Phone (251) 378-6500

5750A Southland Dr
Mobile, AL 36693
Phone (251) 450-5901

2400 Gordon Smith Dr
Mobile, AL 36617
Phone (251) 305-4660

158 Regal Row
Houma, LA 70360
Phone (985) 876-8889

1415 Tulane Ave
New Orleans, LA 70112
Phone (504) 588-2300

1430 Tulane Ave
#22
New Orleans, LA 70112

1440 Canal St
#53
New Orleans, LA 70112
Phone (504) 988-2201

2832 Burdette St
New Orleans, LA 70125
Phone (504) 866-2741

157 Twin Oaks Dr
Raceland, LA 70394
Phone (985) 537-6823

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/IHJJCA

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1149552000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665100800000",
    "number": "1891734455",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5750A SOUTHLAND DR",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366933316",
            "telephone_number": "251-450-5916",
            "fax_number": "251-662-7297"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 ROPER LN",
            "city": "DAPHNE",
            "state": "AL",
            "postal_code": "365265274",
            "telephone_number": "251-450-2211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DETRINIS",
        "first_name": "ROBERT",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-06",
        "last_updated": "2022-10-07",
        "certification_date": "2022-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "LA9582R",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "AL",
            "license": "MD.44998",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1962520",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Daphne, AL

Sources for this page

Verify at the official NPI Registry.