William Trent Massengale, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

023151 Issued in LA

Practice address

17503 Old Jefferson Hwy
Prairieville, LA 70769-3930

Phone

(225) 313-4560

Fax

(225) 673-3069

NPI assigned

Oct 5, 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: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

Louisiana State University School of Medicine in New Orleans, 1996

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Lsuhn Billing LLCGroup PAC ID 0446337802, 203 clinicians

W Trent Massengale MD LLCGroup PAC ID 3173762283, 4 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.55 of 100Reported as individual

Quality

63.1

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• W Trent Massengale, MD LLC

  • Dermatology Physician
  • Prairieville, LA
  • NPI 1255774287
  Medicare reassignment Care Compare group NPD Authorized official
• Lsuhn Billing LLC

  • Multi-Specialty Clinic/Center
  • Lafayette, LA
  • NPI 1992975775
  Medicare reassignment Care Compare group NPD
• Dermatology Clinic a Professional Medical Corporation

  • Dermatology Physician
  • Baton Rouge, LA
  • NPI 1972591170
  Medicare reassignment NPD
• Lsuhn Billing LLC

  • Oral and Maxillofacial Surgery (Dentist)
  • Baton Rouge, LA
  • NPI 1306247556
  NPD

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

{
    "created_epoch": "1128470400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724284800000",
    "number": "1952398893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17503 OLD JEFFERSON HWY",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "70769",
            "telephone_number": "225-313-4560",
            "fax_number": "225-769-0471"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17503 OLD JEFFERSON HWY",
            "city": "PRAIRIEVILLE",
            "state": "LA",
            "postal_code": "707693930",
            "telephone_number": "225-313-4560",
            "fax_number": "225-673-3069"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "163 Burgin Ave",
            "address_purpose": "LOCATION",
            "city": "Baton Rouge",
            "state": "LA",
            "postal_code": "708084925",
            "country_code": "US",
            "telephone_number": "225-313-4560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MASSENGALE",
        "first_name": "WILLIAM",
        "middle_name": "TRENT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-05",
        "last_updated": "2024-08-22",
        "certification_date": "2024-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "LA",
            "license": "023151",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1530000",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Natalie Gayle Martin
• Tyra Marie Martin
• Angele Renee Martinez
• Sarai Martinez
• Latoya Nicole Mason, APRN
• Isabel Wynne Mathes
• Shannon G Matthews, PSY.D, LCSW
• Stefan Matthews
• Jacie Lynn Mayers
• Kyle Joseph McAlister

• Dermatology Physician in Prairieville, LA
• Providers in Prairieville, LA by specialty
• Dermatology Physician in Louisiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2024; 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.