Nicholas Cefalu Jr., MD
Individual provider Active NPI Specialist · Amite, LA
NPI 1992834816 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1992834816
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Specialist 174400000X
- License
- 14724 (LA)
- Practice address
- 112 E Chestnut St
Amite, LA 70422-2802 - Phone
- (985) 748-3272
- Fax
- (985) 748-3838
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in LA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: Yes
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041116000076 | LA | Practitioner - Family Practice | 2365406725 | Practice locations: Amite, LA |
National Provider Directory
- Medicare enrollment (NPD)
- No
- HHS exclusion list flag
- The National Provider Directory flags this NPI as appearing on an HHS exclusion list.
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 14724 | LA | MD | Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Baton Rouge Cardiology Center | Past | Accepting new patients | |
| Checkups - la LLC | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | 14724 | LA | Yes |
Addresses
Primary practice location
112 E Chestnut St
Amite, LA 70422-2802
Mailing address
PO Box 265
Amite, LA 70422-0265
Phone (985) 748-3272
Other providers in Amite, LA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.