John Francis Fidanza III, PSY.D.

Primary specialty

Prescribing (Medical) PsychologistTaxonomy code 103TP0016X

License

1040MP Issued in LA

Practice address

6351 Main St
Zachary, LA 70791-4038

Phone

(225) 306-2000

Fax

(225) 658-1282

NPI assigned

Jun 14, 2005

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in LA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

HIV-AIDS Alliance for Region TwoGroup PAC ID 4880981158, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: john.fidanza@shchc.directbygreenway.com

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.

• HIV-AIDS Alliance for Region Two

  • Federally Qualified Health Center (FQHC)
  • Baton Rouge, LA
  • NPI 1437527900
  Medicare reassignment Care Compare group
• Ochsner Clinic LLC

  • General Practice Physician
  • New Orleans, LA
  • NPI 1538151428
  Medicare reassignment NPD
• HIV-AIDS Alliance for Region Two

  dba Open Health Care Clinic

  • Federally Qualified Health Center (FQHC)
  • Baton Rouge, LA
  • NPI 1518729623
  NPD
• Ochsner Clinic LLC

  dba Diabetes Prevention Program

  • Registered Dietitian
  • Covington, LA
  • NPI 1013747039
  NPD
• Ochsner Clinic LLC

  dba Ochsner Clinic LLC (BR)

  • Internal Medicine Physician
  • Baton Rouge, LA
  • NPI 1407848443
  NPD
• Shields & Fidanza, LLC

  • Clinical Psychologist
  • Louisville, KY
  • NPI 1689724999
  NPD (past)

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

{
    "created_epoch": "1118707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437436800000",
    "number": "1902801392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 770",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707910770",
            "telephone_number": "225-306-2000",
            "fax_number": "225-658-1249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6351 MAIN ST",
            "city": "ZACHARY",
            "state": "LA",
            "postal_code": "707914038",
            "telephone_number": "225-306-2000",
            "fax_number": "225-658-1282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIDANZA",
        "first_name": "JOHN",
        "middle_name": "FRANCIS",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "PSY.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-14",
        "last_updated": "2015-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TP0016X",
            "taxonomy_group": "",
            "desc": "Psychologist, Prescribing (Medical)",
            "state": "LA",
            "license": "1040MP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2125958",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Fast Lane of Zachary LLC
• Fast LLC (Fast Accurate Safe Transporting LLC)
• Cristina M Faucheux, PT
• Jeffrey Charles Faucheux, ATC, LAT
• Emily Rose Fernandez, PA-C
• Samuel B. Field, MD
• Robert L Fillman, P.A.
• Kaelyn Elizabeth Fitzek
• Jasmine Fitzgerald, PHARMD
• Alayna Flotte

• Prescribing (Medical) Psychologist in Zachary, LA
• Providers in Zachary, LA by specialty
• Prescribing (Medical) Psychologist in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.