Theresa Kittelson Lago, PA-C

Primary specialty

Surgical Physician AssistantTaxonomy code 363AS0400X

License

TEMP Issued in LA

Practice address

200 Henry Clay Ave
New Orleans, LA 70118-5720

Phone

(504) 896-9569

NPI assigned

Jan 22, 2007

Last updated

Jan 26, 2009By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Children's Hospital

  dba Manning Family Children's

  • Specialist
  • New Orleans, LA
  • NPI 1043230873
  Medicare reassignment
• Children's Hospital

  dba Manning Family Children's - Physician Billing

  • Specialist
  • New Orleans, LA
  • NPI 1306156138
  Medicare reassignment
• Children's Hospital

  • End-Stage Renal Disease (ESRD) Treatment Clinic/Center
  • New Orleans, LA
  • NPI 1568597649
  NPD

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

{
    "created_epoch": "1169424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232928000000",
    "number": "1912051624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-896-9569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 HENRY CLAY AVE",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701185720",
            "telephone_number": "504-896-9569"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAGO",
        "first_name": "THERESA",
        "middle_name": "KITTELSON",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-22",
        "last_updated": "2009-01-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "LA",
            "license": "TEMP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lagniappe Pediatric Dentistry (Petite Krewe Pediatric Dentistry)
• Lagniappe Pediatrics Rehab & Therapy
• Lagniappe Pharmacy 7, LLC (Lagniappe Pharmacy 7)
• Francisco Lago-Velez, M.D.
• Mary-Elizabeth Lago, MD
• Marisol Lagos, PSS
• Sharon Rocio Lagos, PA-C
• Racheal Lagrue
• Chad M Lahman, FNP-C
• Sarah Gloria Lain, M.D.

• Surgical Physician Assistant in New Orleans, LA
• Providers in New Orleans, LA by specialty
• Surgical Physician Assistant in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2009; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.