Individual provider Active NPI

Garic Grisbaum, M.D.

  • Psychiatry Physician
  • Mandeville, LA
National Provider Identifier
1902217581
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
307905 Issued in LA
Practice address
900 Wilkinson St
Mandeville, LA 70448-3533
Phone
(985) 624-4450
Fax
(985) 624-4461
NPI assigned
May 16, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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 307905 LA Primary
Addiction Medicine (Psychiatry & Neurology) Physician 2084A0401X 23982 MS

Addresses

Primary practice location

900 Wilkinson St
Mandeville, LA 70448-3533

Mailing address

4512 Orleans Blvd
Jefferson, LA 70121-1224
Phone (504) 905-8970

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, LA, GA, TX4 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 4

Enrollment IDStateProvider typePAC IDDetails
I20210406000398 MS Practitioner - Psychiatry 6002223252 Reassigns benefits to 1 organization
I20210930000341 LA Practitioner - Psychiatry 6002223252 Reassigns benefits to 2 organizations
I20231016001066 GA Practitioner - Psychiatry 6002223252
I20231107003667 TX Practitioner - Psychiatry 6002223252 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Louisiana State University School of Medicine in New Orleans, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

835 Pride Dr
Suite B
Hammond, LA 70401-9527
Phone (985) 543-4730

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
23982MSMDAddiction Medicine (Psychiatry & Neurology) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Impact Behavioral Counseling LLC CurrentSince Feb 1, 2021 Accepting new patients
Florida Parishes Human Services Authority CurrentSince Oct 18, 2022 Accepting new patients
Gracious Minds Counseling and Supervision Inc. CurrentSince Sep 29, 2023 Accepting new patients
Florida Parishes Human Services Authority CurrentSince Oct 18, 2022 Accepting new patients
Nurocoach Medical Group PLLC Psychiatry CurrentSince Jan 4, 2023 Accepting new patients
Administrators of the Tulane Educational Fund Past Accepting new patients
Florida Parishes Human Services Authority Past Accepting new patients

Locations

48 Medical Park Dr E
Ste 453
Birmingham, AL 35235
Phone (205) 517-7730

1000 Urban Center Dr
Ste 600
Vestavia, AL 35242
Phone (205) 208-0312

2585 Gresham Rd SE
Ste 100
Atlanta, GA 30316

400 Georgia Ave
Ste 1
Bogalusa, LA 70427
Phone (985) 732-6610

1951 Florida Ave SW
#D
Denham Springs, LA 70726

1951 Florida Ave SW
Denham Springs, LA 70726
Phone (225) 665-0473

1951 Florida Ave SW
Ste D
Denham Springs, LA 70726
Phone (225) 665-0473

835 Pride Dr
Ste B
Hammond, LA 70401
Phone (985) 543-4333

900 Wilkinson St
Mandeville, LA 70448
Phone (985) 624-4450

650 Poydras St
Ste 1400
New Orleans, LA 70130
Phone (855) 235-2872

2331 Carey St
Slidell, LA 70458
Phone (985) 646-6406

3600 Bluecutt Rd
Ste 202
Columbus, MS 39705
Phone (662) 434-4210

1200 N State St
Ste 455
Jackson, MS 39202
Phone (601) 957-7343

5 Dunnbarr
Laurel, MS 39440
Phone (662) 434-4210

4075 Pemberton Square Blvd
Vicksburg, MS 39180
Phone (601) 883-0264

2800 Kirby Dr
Ste A110
Houston, TX 77098

101 Southwestern Blvd
Ste 200
Sugar Land, TX 77478
Phone (346) 298-3790

Organizations & group practices 7

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": "1400198400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745452800000",
    "number": "1902217581",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4512 ORLEANS BLVD",
            "city": "JEFFERSON",
            "state": "LA",
            "postal_code": "701211224",
            "telephone_number": "504-905-8970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 WILKINSON ST",
            "city": "MANDEVILLE",
            "state": "LA",
            "postal_code": "704483533",
            "telephone_number": "985-624-4450",
            "fax_number": "985-624-4461"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GRISBAUM",
        "first_name": "GARIC",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-05-16",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "307905",
            "primary": true
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "MS",
            "license": "23982",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mandeville, LA

Sources for this page

Verify at the official NPI Registry.