Individual provider Active NPI

Charles Eliot Degravelles, MD

  • Psychiatry Physician
  • Baton Rouge, LA
National Provider Identifier
1942300280
Registry record updated Dec 13, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
301841 Issued in LA
Practice address
9001 Summa Ave
Baton Rouge, LA 70809-3726
Phone
(225) 761-5820
Fax
(225) 761-5369
NPI assigned
Sep 25, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2016

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 41515 TX
Psychiatry Physician 2084P0800X 301841 LA Primary

Addresses

Primary practice location

9001 Summa Ave
Baton Rouge, LA 70809-3726

Mailing address

1514 Jefferson Hwy
New Orleans, LA 70121-2429
Phone (504) 842-4000

Other identifiers 2

IdentifierTypeStateIssuer
05372271MedicaidMS
2429507MedicaidLA

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
I20161005000100 LA Practitioner - Psychiatry 9234131871 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Louisiana State University School of Medicine in New Orleans, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ochsner Clinic LLCGroup PAC ID 8224933619, 2,845 clinicians

Practice addresses (Care Compare)

10310 The Grove Blvd
Baton Rouge, LA 70836-6455
Phone (225) 761-5200

104 Acadia Park Dr
Raceland, LA 70394-2618
Phone (985) 537-3211

Hospital & facility affiliations

  • Ochsner Medical Center - Baton Rouge Hospital, Baton Rouge, LA, CCN 190202

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
41515TXMDDentist
301841LAMDPsychiatry Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Ochsner Clinic LLC Current Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 22, 2016 Accepting new patients
Ochsner Clinic LLC CurrentSince Aug 22, 2016 Accepting new patients

Locations

9001 Summa Ave
Baton Rouge, LA 70809

10310 The Grove Blvd
Baton Rouge, LA 70836
Phone (225) 761-5239

1514 Jefferson Hwy
New Orleans, LA 70121

104 Acadia Park Dr
Raceland, LA 70394
Phone (985) 537-3211

Interoperability endpoints

  • Direct secure messaging: cdegravelles397805@direct.ochsner.org

Organizations & group practices 3

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.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1159142400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1481587200000",
    "number": "1942300280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1514 JEFFERSON HWY",
            "city": "NEW ORLEANS",
            "state": "LA",
            "postal_code": "701212429",
            "telephone_number": "504-842-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9001 SUMMA AVE",
            "city": "BATON ROUGE",
            "state": "LA",
            "postal_code": "708093726",
            "telephone_number": "225-761-5820",
            "fax_number": "225-761-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEGRAVELLES",
        "first_name": "CHARLES",
        "middle_name": "ELIOT",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-25",
        "last_updated": "2016-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "TX",
            "license": "41515",
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "LA",
            "license": "301841",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05372271",
            "state": "MS"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2429507",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Baton Rouge, LA

Sources for this page

Verify at the official NPI Registry.