Individual provider Active NPI

Nicholas Cefalu Jr., MD

  • Specialist
  • Amite, LA
National Provider Identifier
1992834816
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
14724 Issued in LA
Practice address
112 E Chestnut St
Amite, LA 70422-2802
Phone
(985) 748-3272
Fax
(985) 748-3838
NPI assigned
Mar 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 14724 LA Primary

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

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
I20041116000076 LA Practitioner - Family Practice 2365406725 Practice locations: Amite, LA

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
14724LAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Baton Rouge Cardiology Center Past Accepting new patients
Checkups - la LLC Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1173052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1992834816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 265",
            "city": "AMITE",
            "state": "LA",
            "postal_code": "704220265",
            "telephone_number": "985-748-3272",
            "fax_number": "985-748-3838"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "112 E CHESTNUT ST",
            "city": "AMITE",
            "state": "LA",
            "postal_code": "704222802",
            "telephone_number": "985-748-3272",
            "fax_number": "985-748-3838"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CEFALU",
        "first_name": "NICHOLAS",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "LA",
            "license": "14724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Amite, LA

Sources for this page

Verify at the official NPI Registry.